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HIV drug resistance detected during low-level viraemia is associated with subsequent virologic failure.


ABSTRACT: The clinical implications of emergent HIV drug resistance on samples with low-level viraemia (LLV <1000?copies/ml) remain unclear. We undertook the present analysis to evaluate the impact of emergent HIV drug resistance at LLV on the risk of subsequent virologic failure.One thousand, nine hundred and sixty-five patients had genotype results at LLV. Risk of virologic failure (?1000?copies/ml) after LLV was evaluated by Kaplan-Meier analysis and Cox proportional hazards regression. Resistance was assessed using the Stanford algorithm or virtual phenotypes. Patients were grouped into four susceptibility categories ('GSS' or 'vPSS') during LLV, corresponding to the number of 'active' drugs prescribed: <1; 1-1.5; 2-2.5; and ?3.A total of 1702 patients with follow-up on constant therapy were eligible for analysis. Participants excluded due to changing therapy or loss to follow-up before their next observation had mostly similar characteristics to included participants. There was a 'dose-dependent' increase in the hazard ratio for virologic failure with susceptibility categories at LLV. Compared with a GSS of at least 3, hazard ratios for virologic failure were 1.4 for GSS 2-2.5; 2.0 for GSS 1-1.5; and 3.0 for GSS less than 1 (P?

SUBMITTER: Swenson LC 

PROVIDER: S-EPMC4278403 | biostudies-other | 2014 May

REPOSITORIES: biostudies-other

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HIV drug resistance detected during low-level viraemia is associated with subsequent virologic failure.

Swenson Luke C LC   Min Jeong Eun JE   Woods Conan K CK   Cai Eric E   Li Jonathan Z JZ   Montaner Julio S G JS   Harrigan P Richard PR   Gonzalez-Serna Alejandro A  

AIDS (London, England) 20140501 8


<h4>Background</h4>The clinical implications of emergent HIV drug resistance on samples with low-level viraemia (LLV <1000 copies/ml) remain unclear. We undertook the present analysis to evaluate the impact of emergent HIV drug resistance at LLV on the risk of subsequent virologic failure.<h4>Methods</h4>One thousand, nine hundred and sixty-five patients had genotype results at LLV. Risk of virologic failure (≥1000 copies/ml) after LLV was evaluated by Kaplan-Meier analysis and Cox proportional  ...[more]

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