University Library
  • Login
A gateway to Melbourne's research publications
Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience.
View Item 
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Doherty Institute
  • Doherty Institute - Research Publications
  • View Item
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Doherty Institute
  • Doherty Institute - Research Publications
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

    High prevalence of PI resistance in patients failing second-line ART in Vietnam

    Thumbnail
    Download
    Published version (1.697Mb)

    Citations
    Scopus
    Web of Science
    Altmetric
    10
    11
    Author
    Vu, PT; Vo, MQ; Day, JN; Nguyen, TC; Shikuma, CM; Farrar, J; Nguyen, VVC; Thwaites, GE; Dunstan, SJ; Thuy, L
    Date
    2016-03-01
    Source Title
    Journal of Antimicrobial Chemotherapy
    Publisher
    OXFORD UNIV PRESS
    University of Melbourne Author/s
    Dunstan, Sarah
    Affiliation
    Doherty Institute
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Vu, P. T., Vo, M. Q., Day, J. N., Nguyen, T. C., Shikuma, C. M., Farrar, J., Nguyen, V. V. C., Thwaites, G. E., Dunstan, S. J. & Thuy, L. (2016). High prevalence of PI resistance in patients failing second-line ART in Vietnam. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 71 (3), pp.762-774. https://doi.org/10.1093/jac/dkv385.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/258346
    DOI
    10.1093/jac/dkv385
    Abstract
    BACKGROUND: There are limited data from resource-limited settings on antiretroviral resistance mutations that develop in patients failing second-line PI ART. METHODS: We performed a cross-sectional virological assessment of adults on second-line ART for ≥6 months between November 2006 and December 2011, followed by a prospective follow-up over 2 years of patients with virological failure (VF) at the Hospital for Tropical Diseases, Vietnam. VF was defined as HIV RNA concentrations ≥1000 copies/mL. Resistance mutations were identified by population sequencing of the pol gene and interpreted using the 2014 IAS-USA mutation list and the Stanford algorithm. Logistic regression modelling was performed to identify predictors of VF. RESULTS: Two hundred and thirty-one patients were enrolled in the study. The median age was 32 years; 81.0% were male, 95.7% were on a lopinavir/ritonavir-containing regimen and 22 (9.5%) patients had VF. Of the patients with VF, 14 (64%) carried at least one major protease mutation [median: 2 (IQR: 1-3)]; 13 (59%) had multiple protease mutations conferring intermediate- to high-level resistance to lopinavir/ritonavir. Mutations conferring cross-resistance to etravirine, rilpivirine, tipranavir and darunavir were identified in 55%, 55%, 45% and 27% of patients, respectively. Higher viral load, adherence <95% and previous indinavir use were independent predictors of VF. The 2 year outcomes of the patients maintained on lopinavir/ritonavir included: death, 7 (35%); worsening virological/immunological control, 6 (30%); and virological re-suppression, 5 (25%). Two patients were switched to raltegravir and darunavir/ritonavir with good HIV control. CONCLUSIONS: High-prevalence PI resistance was associated with previous indinavir exposure. Darunavir plus an integrase inhibitor and lamivudine might be a promising third-line regimen in Vietnam.

    Export Reference in RIS Format     

    Endnote

    • Click on "Export Reference in RIS Format" and choose "open with... Endnote".

    Refworks

    • Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References


    Collections
    • Minerva Elements Records [45689]
    • Doherty Institute - Research Publications [371]
    Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs

    BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    My AccountLoginRegister
    StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors