Antiretroviral Drug Resistance Among Children and Youth in the United States With Perinatal HIV.
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ABSTRACT:
SUBMITTER: Van Dyke RB
PROVIDER: S-EPMC4901868 | biostudies-literature | 2016 Jul
REPOSITORIES: biostudies-literature
Publications
Antiretroviral Drug Resistance Among Children and Youth in the United States With Perinatal HIV.
Van Dyke Russell B RB Patel Kunjal K Kagan Ron M RM Karalius Brad B Traite Shirley S Meyer William A WA Tassiopoulos Katherine K KK Seage George R GR Seybolt Lorna M LM Burchett Sandra S Hazra Rohan R Lurie Robert H RH Yogev Ram R Sanders Margaret Ann MA Malee Kathleen K Hunter Scott S Shearer William W Paul Mary M Cooper Norma N Harris Lynnette L Purswani Murli M Baig Mahboobullah M Cintron Anna A Puga Ana A Navarro Sandra S Garvie Patricia P Blood James J Burchett Sandra S Karthas Nancy N Kammerer Betsy B Wiznia Andrew A Burey Marlene M Nozyce Molly M Dieudonne Arry A Bettica Linda L Adubato Susan S Chen Janet J Bulkley Maria Garcia MG Ivey Latreaca L Grant Mitzie M Knapp Katherine K Allison Kim K Wilkins Megan M Acevedo-Flores Midnela M Rios Heida H Olivera Vivian V Silio Margarita M Jones Medea M Sirois Patricia P Spector Stephen S Norris Kim K Nichols Sharon S McFarland Elizabeth E Katai Alisa A Dunn Jennifer J Paul Suzanne S Scott Gwendolyn G Bryan Patricia P Willen Elizabeth E
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20160407 1
Among 234 US youths with perinatal human immunodeficiency virus, 75% had antiretroviral resistance, substantially higher than that of the reference laboratory overall (36%-44%). Resistance to newer antiretrovirals and to all antiretrovirals in a class was uncommon. The only factor independently associated with future resistance was a higher peak viral load. ...[more]
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Project description:ObjectiveTo analyze HIV drug resistance among MSM recruited for participation in the HPTN 078 study, which evaluated methods for achieving and maintaining viral suppression in HIV-infected MSM.MethodsIndividuals were recruited at four study sites in the United States (Atlanta, Georgia; Baltimore, Maryland; Birmingham, Alabama; and Boston, Massachusetts; 2016-2017). HIV genotyping was performed using samples collected at study screening or enrollment. HIV drug resistance was evaluated using the Stanford v8.7 algorithm. A multiassay algorithm was used to identify individuals with recent HIV infection. Clustering of HIV sequences was evaluated using phylogenetic methods.ResultsHigh-level HIV drug resistance was detected in 44 (31%) of 142 individuals (Atlanta: 21%, Baltimore: 29%, Birmingham: 53%, Boston: 26%); 12% had multiclass resistance, 16% had resistance to tenofovir or emtricitabine, and 8% had resistance to integrase strand transfer inhibitors (INSTIs); 3% had intermediate-level resistance to second-generation INSTIs. In a multivariate model, self-report of ever having been on antiretroviral therapy (ART) was associated with resistance (P?=?0.005). One of six recently infected individuals had drug resistance. Phylogenetic analysis identified five clusters of study sequences; two clusters had shared resistance mutations.ConclusionHigh prevalence of drug resistance was observed among MSM. Some had multiclass resistance, resistance to drugs used for preexposure prophylaxis (PrEP), and INSTI resistance. These findings highlight the need for improved HIV care in this high-risk population, identification of alternative regimens for PrEP, and inclusion of integrase resistance testing when selecting ART regimens for MSM in the United States.
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