Skip Navigation LinksHome > November 1, 2011 - Volume 58 - Issue 3 > Genotypic Resistance at Viral Rebound Among Patients Who Rec...
JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e3182278c29
Brief Report: Clinical Science

Genotypic Resistance at Viral Rebound Among Patients Who Received Lopinavir/Ritonavir-Based or Efavirenz-Based First Antiretroviral Therapy in South Africa

Dlamini, J. Nomthandazo MBBCh*; Hu, Zonghui PhD; Ledwaba, Johanna MS; Morris, Lynn DPhil; Maldarelli, Frank M. MD, PhD§; Dewar, Robin L. PhD; Highbarger, Helene C. MS; Somaroo, Harsha MBBCh; Sangweni, Phumelele BSc(Hon)#; Follmann, Dean A. PhD; Pau, Alice K. PharmD; Phidisa II Study Team

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Abstract

Abstract: Nonnucleoside reverse transcriptase inhibitor–drug resistance mutations (DRM) are increasingly reported in Africans failing their first antiretroviral regimen. The Phidisa II trial randomized treatment-naive participants to lopinavir/ritonavir or efavirenz with stavudine + lamivudine or zidovudine + didanosine. We report the prevalence of DRM in subjects who achieved HIV RNA <400 copies per milliliter at 6 months, but subsequently had 2 consecutive HIV RNA >1000 copies per milliliter. Sixty-eight participants fulfilled the inclusion criteria. nonnucleoside reverse transcriptase inhibitor–DRM were found in 17 of 36 (47.2%) efavirenz recipients, and M184V/I mutation in 14 of 40 (35.0%) lamivudine recipients. No protease inhibitor mutation was identified in 38 lopinavir/ritonavir recipients. This is one of the first studies in Africa confirming the paucity of protease inhibitor–associated DRM despite virologic failure.

© 2011 Lippincott Williams & Wilkins, Inc.

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