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dc.contributor.authorVu, PT
dc.contributor.authorVo, MQ
dc.contributor.authorDay, JN
dc.contributor.authorNguyen, TC
dc.contributor.authorShikuma, CM
dc.contributor.authorFarrar, J
dc.contributor.authorNguyen, VVC
dc.contributor.authorThwaites, GE
dc.contributor.authorDunstan, SJ
dc.contributor.authorThuy, L
dc.date.accessioned2020-12-22T05:43:42Z
dc.date.available2020-12-22T05:43:42Z
dc.date.issued2016-03-01
dc.identifierpii: dkv385
dc.identifier.citationVu, 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.
dc.identifier.issn0305-7453
dc.identifier.urihttp://hdl.handle.net/11343/258346
dc.description.abstractBACKGROUND: 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.
dc.languageEnglish
dc.publisherOXFORD UNIV PRESS
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleHigh prevalence of PI resistance in patients failing second-line ART in Vietnam
dc.typeJournal Article
dc.identifier.doi10.1093/jac/dkv385
melbourne.affiliation.departmentDoherty Institute
melbourne.source.titleJournal of Antimicrobial Chemotherapy
melbourne.source.volume71
melbourne.source.issue3
melbourne.source.pages762-774
dc.rights.licenseCC BY
melbourne.elementsid1040776
melbourne.contributor.authorDunstan, Sarah
dc.identifier.eissn1460-2091
melbourne.accessrightsOpen Access


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