The impact of transmitted drug resistance on treatment selection and outcome of first-line highly active antiretroviral therapy (HAART)

By:

Bansi, L

Contributor(s):

Publication details: 2010ISSN:

15254135

Uniform titles:

Journal of AIDS

Online resources:

Summary: OBJECTIVE: The study aim was to determine howresistance testing influences outcome of first-line highly activeantiretroviral therapy (HAART) in routine practice in the United Kingdom.METHODS: The prevalence of transmitted drug resistance and the genotypic sensitivity score (GSS) of first-line HAARTregimens were determined using data from the UK Collaborative HIV Cohort(CHIC) Study. Factors associatedwith starting a regimen with a reduced GSS and subsequent virological responseswere analyzed by logistic and Cox regression.RESULTS: Amongst patients tested in 1999–2006, 116 of 1175 (10%) had $1resistance mutation;64 patients (5.4%) had $1 mutation associated with resistance to drugsin the initial HAART regimen and 54 (4.6%) showed a GSS, 3. Factorsindependently associated with a GSS, 3 were starting HAART in 1999–2001 vs.2004–2006 (odds ratio = 2.63; 95% confidence interval: 1.19 to 5.83) and use ofritonavir-boosted protease inhibitor (PI/r)–based vs. nonnucleoside reversetranscriptase inhibitor–based regimens (1.97; 1.06 to 3.64). AGSS .3 wasindependently associated with virological suppression(hazard ratio for GSS, 3 =0.60; 95% confidence interval 0.41 to 0.87).CONCLUSIONS: Most patients starting HAART after undergoing resistance testingreceived regimens with a GSS $3. PI/r-based therapy was often selected inpatients with resistance to the nucleoside reverse transcriptase inhibitorbackbone. Low GSS predicted poor virological suppression and the associationpersisted after adjusting for PI/r use

Holdings
Item type	Home library	Collection	Class number	Status	Date due	Barcode
Book	Ferriman information and Library Service (North Middlesex) Shelves	Staff publications for NMDX		Available

NMUH Staff Publications

OBJECTIVE: The study aim was to determine howresistance testing influences outcome of first-line highly activeantiretroviral therapy (HAART) in routine practice in the United Kingdom.METHODS: The prevalence of transmitted&nbsp;drug&nbsp;resistance and the genotypic sensitivity score (GSS) of first-line HAARTregimens were determined using&nbsp;data&nbsp;from the UK Collaborative HIV Cohort(CHIC) Study. Factors associatedwith starting a regimen with a reduced GSS and subsequent virological responseswere analyzed by logistic and Cox regression.RESULTS: Amongst patients tested in 1999–2006, 116 of 1175 (10%) had $1resistance&nbsp;mutation;64 patients (5.4%) had $1&nbsp;mutation&nbsp;associated with resistance to drugsin the initial HAART regimen and 54 (4.6%) showed a GSS, 3. Factorsindependently associated with a GSS, 3 were starting HAART in 1999–2001 vs.2004–2006 (odds ratio = 2.63; 95% confidence interval: 1.19 to 5.83) and use ofritonavir-boosted protease inhibitor (PI/r)–based vs. nonnucleoside reversetranscriptase inhibitor–based regimens (1.97; 1.06 to 3.64). AGSS .3 wasindependently associated with virological suppression(hazard ratio for GSS, 3 =0.60; 95% confidence interval 0.41 to 0.87).CONCLUSIONS: Most patients starting HAART after undergoing resistance testingreceived regimens with a GSS $3. PI/r-based therapy was often selected inpatients with resistance to the nucleoside reverse transcriptase inhibitorbackbone. Low GSS predicted poor virological suppression and the associationpersisted after adjusting for PI/r use

There are no comments on this title.

to post a comment.