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2016-01-28Zeitschriftenartikel DOI: 10.1016/S1473-3099(15)00536-8
Global epidemiology of drug resistance after failure of WHO recommended first-line regimens for adult HIV-1 infection: a multicentre retrospective cohort study
dc.contributor.authorRobert Koch-Institut
dc.date.accessioned2018-05-07T19:09:49Z
dc.date.available2018-05-07T19:09:49Z
dc.date.created2016-07-28
dc.date.issued2016-01-28none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/reii018Z8h0sM/PDF/24fS6YsHLnWkg.pdf
dc.identifier.urihttp://edoc.rki.de/176904/2361
dc.description.abstractBackground: Antiretroviral therapy (ART) is crucial for controlling HIV-1 infection through wide-scale treatment as prevention and pre-exposure prophylaxis (PrEP). Potent tenofovir disoproxil fumarate-containing regimens are increasingly used to treat and prevent HIV, although few data exist for frequency and risk factors of acquired drug resistance in regions hardest hit by the HIV pandemic. We aimed to do a global assessment of drug resistance after virological failure with first-line tenofovir-containing ART. Methods: The TenoRes collaboration comprises adult HIV treatment cohorts and clinical trials of HIV drug resistance testing in Europe, Latin and North America, sub-Saharan Africa, and Asia. We extracted and harmonised data for patients undergoing genotypic resistance testing after virological failure with a first-line regimen containing tenofovir plus a cytosine analogue (lamivudine or emtricitabine) plus a non-nucleotide reverse-transcriptase inhibitor (NNRTI; efavirenz or nevirapine). We used an individual participant-level meta-analysis and multiple logistic regression to identify covariates associated with drug resistance. Our primary outcome was tenofovir resistance, defined as presence of K65R/N or K70E/G/Q mutations in the reverse transcriptase (RT) gene. Findings: We included 1926 patients from 36 countries with treatment failure between 1998 and 2015. Prevalence of tenofovir resistance was highest in sub-Saharan Africa (370/654 [57%]). Pre-ART CD4 cell count was the covariate most strongly associated with the development of tenofovir resistance (odds ratio [OR] 1·50, 95% CI 1·27–1·77 for CD4 cell counteng
dc.language.isoger
dc.publisherRobert Koch-Institut, Infektionsepidemiologie
dc.subject.ddc610 Medizin
dc.titleGlobal epidemiology of drug resistance after failure of WHO recommended first-line regimens for adult HIV-1 infection: a multicentre retrospective cohort study
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-10045921
dc.identifier.doi10.1016/S1473-3099(15)00536-8
dc.identifier.doihttp://dx.doi.org/10.25646/2286
local.edoc.container-titleLancet Infectious Diseases
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2815%2900536-8/abstract
local.edoc.container-publisher-nameElsevier
local.edoc.container-volume16
local.edoc.container-year2016

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