Prevalence of genotypic and phenotypic HIV-1 drug-resistant strains among patients who have rebound in viral load while receiving antiretroviral therapy in the UNAIDS-Drug Access Initiative in Abidjan, Cote d'Ivoire

被引:13
作者
Adjé-Touré, C
Celestin, B
Hanson, D
Roels, TH
Hertogs, K
Larder, B
Diomande, F
Peeters, M
Eholié, S
Lackritz, E
Chorba, T
Nkengasong, JN
机构
[1] Project RETRO CI, Virol Lab, Abidjan, Cote Ivoire
[2] Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Natl Ctr STD HIV & TB Prevent, Atlanta, GA USA
[3] VIRCO NV, Mechelen, Belgium
[4] VIRCO, Cambridge, England
[5] IRD, Retrovirus Lab, Montpellier, France
[6] Univ Hosp, Infect Dis Clin, Abidjan, Cote Ivoire
关键词
Africa; antiretroviral; drug resistance; HIV-1; viral load rebound;
D O I
10.1097/00002030-200317003-00004
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: To determine the prevalence of genotypic and phenotypic antiretroviral (ARV) drug-resistant HIV-1 strains among patients with viral load rebound while receiving ARV therapy in Abidjan, Cote d'Ivoire. Methods: Between August 1998 and April 2000, we selected all patients (n = 241) who had received ARV drug therapy for at least 6 months in the UNAIDS-Drug Access Initiative (DAI), in Abidjan. We analyzed for genotypic and phenotypic drug resistance among 97 (40%) of the 241 patients who had a rebound in plasma viral load, defined as an initial decrease of > 0.5 log(10) copies/ml followed by a subsequent increase of > 0.25 log(10) copies/ml. Results: Of the viruses isolated from the 97 patients, 86 (88.7%) had usable sequences and 68 (79%) of the 86 patients had genotypic resistance to at least one reverse transcriptase inhibitor (RTI) or protease inhibitor (PI). Resistant mutations were found for zidovudine in 50 (78%) of 64 patients who had received the drug, 11 (68.7%) of 16 patients on lamivudine, for nevirapine in two (2%), for indinavir in one (1%), and for ritonavir in one (1%). Phenotypic resistance to at least one nucleoside RTI was seen in 45 (56%) of the 80 patients tested, to non-nucleoside RTIs in eight (10%), and to PIs in one (1.3%). Multivariate regression analysis showed factors associated with resistance to be initial treatment with dual therapy (P = 0.04) compared with highly active antiretroviral therapy, and maximal initial viral load response (P = 0.006). Conclusion: Our results demonstrate a high prevalence of ARV drug resistance associated with dual ARV therapy. These results indicate the limited role for dual ARV therapy. (C) 2003 Lippincott Williams Wilkins.
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收藏
页码:S23 / S29
页数:7
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