Abstract
We analyzed antiretroviral drug susceptibility in HIV-infected adults failing first- and second-line antiretroviral treatment (ART) in Rakai, Uganda. Samples obtained from participants at baseline (pretreatment) and at the time of failure on first-line ART and second-line ART were analyzed using genotypic and phenotypic assays for antiretroviral drug resistance. Test results were obtained from 73 samples from 38 individuals (31 baseline samples, 36 first-line failure samples, and six second-line failure samples). Four (13%) of the 31 baseline samples had mutations associated with resistance to nucleoside or nonnucleoside reverse transcriptase inhibitors (NRTIs and NNRTIs, respectively). Among the 36 first-line failure samples, 31 (86%) had NNRTI resistance mutations and 29 (81%) had lamivudine resistance mutations; only eight (22%) had other NRTI resistance mutations. None of the six individuals failing a second-line protease inhibitor (PI)-based regimen had PI resistance mutations. Six (16%) of the participants had discordant genotypic and phenotypic test results. Genotypic resistance to drugs included in first-line ART regimens was detected prior to treatment and among participants failing first-line ART. PI resistance was not detected in individuals failing second-line ART. Surveillance for transmitted and acquired drug resistance remains a priority for scale-up of ART.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, N.I.H., Intramural
MeSH terms
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Adolescent
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Adult
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Anti-Retroviral Agents / administration & dosage*
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Antiretroviral Therapy, Highly Active / methods*
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Drug Resistance, Viral*
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Female
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Genotype
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HIV / drug effects*
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HIV / genetics*
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HIV / isolation & purification
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HIV Infections / drug therapy*
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HIV Infections / virology*
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HIV Protease / genetics
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HIV Reverse Transcriptase / genetics
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Humans
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Male
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Microbial Sensitivity Tests
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Molecular Sequence Data
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Mutation, Missense
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Sequence Analysis, DNA
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Treatment Failure
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Uganda
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Young Adult
Substances
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Anti-Retroviral Agents
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HIV Reverse Transcriptase
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HIV Protease
Associated data
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GENBANK/JN652138
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GENBANK/JN652139
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GENBANK/JN652140
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GENBANK/JN652141
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