Document Type
Article
Department
Internal Medicine (East Africa)
Abstract
Background: Transmitted drug resistance (TDR) is increasing in some areas of Africa. Detection of TDR may predict virologic failure of first-line non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART). We evaluated the utility of a relatively inexpensive oligonucleotide ligation assay (OLA) to detect clinically relevant TDR at time of ART initiation.
Methods: Pre-ART plasmas from ART-naive Kenyans initiating an NNRTI-based fixed-dose combination ART in a randomized adherence trial conducted in 2006 were retrospectively analyzed by OLA for mutations conferring resistance to NNRTI (K103N, Y181C, and G190A) and lamivudine (M184V). Post-ART plasmas were analyzed for virologic failure (≥1,000 copies/mL) at 6 month intervals over 18-month follow-up. Pre-ART plasmas of those with virologic failure were evaluated for drug resistance by consensus and 454-pyrosequencing.
Results: Among 386 participants, TDR was detected by OLA in 3.89% [95% Confidence Interval (CI), 2.19-6.33], and was associated with a 10-fold higher rate of virologic failure [Hazard Ratio (HR), 10.39; 95% CI, 3.23-32.41; p
Conclusions: Detection of TDR by a point mutation assay may prevent use of sub-optimal ART.
Publication (Name of Journal)
Journal of Acquired Immune Deficiency Syndromes
Recommended Citation
Chung, M.,
Beck, I. A.,
Dross, S.,
Tapia, K.,
Kiarie, J. N.,
Richardson, B. A.,
Overbaugh, J.,
Sakr, S. R.,
John-Stewart, G. C.,
Frenkel, L. M.
(2014). Oligonucleotide ligation assay detects HIV drug resistance associated with virologic failure among antiretroviral-naive adults in Kenya. Journal of Acquired Immune Deficiency Syndromes, 67(3), 246-253.
Available at:
https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/62
Comments
This work was published before the author joined Aga Khan University.