| Title |
High rate of HIV-1 drug resistance in treatment failure patients in Taiwan, 2009–2014
|
|---|---|
| Published in |
Infection and Drug Resistance, October 2017
|
| DOI | 10.2147/idr.s146584 |
| Pubmed ID | |
| Authors |
Hung-Chin Tsai, I-Tzu Chen, Kuan-Sheng Wu, Yu-Ting Tseng, Cheng-Len Sy, Jui-Kuang Chen, Susan Shin-Jung Lee, Yao-Shen Chen |
| Abstract |
Drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors (PIs) has been associated with loss of viral suppression measured by a rise in HIV-1 RNA levels, a decline in CD4 cell counts, persistence on a failing treatment regimen, and lack of adherence to combination antiretroviral therapy. This study aimed to monitor the prevalence and risk factors associated with drug resistance in Taiwan after failure of first-line therapy. Data from the Veterans General Hospital Surveillance and Monitor Network for the period 2009-2014 were analyzed. Plasma samples from patients diagnosed with virologic failure and an HIV-1 RNA viral load >1000 copies/mL were analyzed by the ViroSeq(™) HIV-1 genotyping system for drug susceptibility. Hazard ratios (HRs) for drug resistance were calculated using a Cox proportional hazard model. From 2009 to 2014, 359 patients were tested for resistance. The median CD4 count and viral load (log) were 214 cells/μL (interquartile range [IQR]: 71-367) and 4.5 (IQR: 3.9-5.0), respectively. Subtype B HIV-1 strains were found in 90% of individuals. The resistance rate to any of the three classes of antiretroviral drugs (NRTI, NNRTI, and PI) was 75.5%. The percentage of NRTI, NNRTI, and PI resistance was 58.6%, 61.4%, and 11.4%, respectively. The risk factors for any class of drug resistance included age ≤35 years (adjusted HR: 2.30, CI: 1.48-3.56; p<0.0001), initial NNRTI-based antiretroviral regimens (adjusted HR: 1.70, CI: 1.10-2.63; p=0.018), and current NNRTI-based antiretroviral regimens when treatment failure occurs (odds ratio: 4.04, CI: 2.47-6.59; p<0.001). There was no association between HIV-1 subtype, viral load, and resistance. This study demonstrated a high level of resistance to NRTI and NNRTI in patients with virologic failure to first-line antiretroviral therapy despite routine viral load monitoring. Educating younger men who have sex with men to maintain good adherence is crucial, as PI use is associated with lower possibility of drug resistance. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 48 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 13 | 27% |
| Researcher | 6 | 13% |
| Student > Doctoral Student | 3 | 6% |
| Student > Postgraduate | 3 | 6% |
| Lecturer | 2 | 4% |
| Other | 6 | 13% |
| Unknown | 15 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 27% |
| Biochemistry, Genetics and Molecular Biology | 6 | 13% |
| Immunology and Microbiology | 3 | 6% |
| Agricultural and Biological Sciences | 2 | 4% |
| Nursing and Health Professions | 2 | 4% |
| Other | 5 | 10% |
| Unknown | 17 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 November 2017.
All research outputs
#17,917,778
of 23,005,189 outputs
Outputs from Infection and Drug Resistance
#923
of 1,681 outputs
Outputs of similar age
#230,807
of 322,475 outputs
Outputs of similar age from Infection and Drug Resistance
#11
of 14 outputs
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