Mutations associated with viral resistance to integrase in individuals initiating dolutegravir-containing antiretroviral therapy: retrospective cohort, Brazil 2017-2019.

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Igor Francisco Chagas Dos Santos, Alexandre Sampaio Moura, Matheus Marchesotti Dutra Ferraz, Carla Maria Gonçalves de Macedo Moreira, Paula Meireles, Maria das Graças Braga
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引用次数: 0

Abstract

Retrospective cohort aimed to analyze viral resistance mutations to integrase in people living with HIV/Aids (PLWHA) in Brazil. Patients receiving first-line therapy with a three-drug antiretroviral (ART) regimen containing dolutegravir (DTG), with HIV-1 genotypic resistance test available after starting treatment, were included. Data from three national databases related to antiretroviral dispensing, LT CD4+ cell count and HIV viral load (VL), and genotyping resistance testing were linked. Ideal adherence was defined as the proportion of days covered (PDC) ≥ 80%. Thirty (7.0%) of the 430 participants had resistance to DTG; five had high and 11 had moderate resistance levels. The N155H (n = 9) and E138K (n = 7) mutations were the most prevalent. DTG mutations were significantly more prevalent among males, whites, and those with HIV-VL count > 100,000 copies/mL, switching to alternative regimens or with resistance mutations to other classes of antiretroviral drugs (p < 0.05). Ideal ART adherence was observed in 52.8% of the participants and it was associated with DTG mutations (p < 0.001). This study described the resistance mutations to DTG in individuals starting treatment with this drug and the characteristics of such individuals. Understanding such a profile is crucial to regions where a DTG-containing regimen is the recommended first-line therapy.

开始含曲地韦抗逆转录病毒治疗的个体中与病毒对整合酶耐药性相关的突变:回顾性队列,巴西2017-2019
回顾性队列旨在分析巴西艾滋病毒/艾滋病(PLWHA)患者整合酶的病毒耐药性突变。接受含多替格拉韦(DTG)的三药抗逆转录病毒(ART)方案一线治疗的患者,在开始治疗后可进行HIV-1基因型耐药试验。来自三个国家数据库的数据与抗逆转录病毒分发、LT CD4+细胞计数和HIV病毒载量(VL)以及基因分型耐药检测相关。理想依从性定义为覆盖天数(PDC)比例≥80%。430名受试者中有30人(7.0%)对DTG有耐药性;5个有高抗性,11个有中等抗性。N155H (n = 9)和E138K (n = 7)突变最为普遍。DTG突变在男性、白人和HIV-VL计数为10万拷贝/mL、改用替代方案或对其他类型抗逆转录病毒药物产生耐药性突变的患者中更为普遍
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来源期刊
CiteScore
3.50
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0.00%
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172
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