HIV Drug Resistance in Adults Receiving Early vs. Delayed Antiretroviral Therapy: HPTN 052.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Palumbo Philip J, Fogel Jessica M, Hudelson Sarah E, Wilson Ethan A, Hart Stephen, Hovind Laura, Piwowar-Manning Estelle, Wallis Carole, Papathanasopoulos Maria A, Morgado Mariza G, Saravanan Shanmugam, Tripathy Srikanth, Eron Joseph J, Gallant Joel E, McCauley Marybeth, Gamble Theresa, Hosseinipour Mina C, Kumarasamy Nagalingeswaran, Hakim James G, Pilotto Jose H, Kumwenda Johnstone, Akelo Victor, Godbole Sheela V, Santos Breno R, Grinsztejn Beatriz, Panchia Ravindre, Chariyalertsak Suwat, Makhema Joseph, Badal-Faesen Sharlaa, Chen Ying Q, Cohen Myron S, Eshleman Susan H
Аннотация
METHODS: Virologic failure was defined as 2 consecutive viral loads >1000 copies/mL >24 weeks after ART initiation. Drug resistance testing was performed for pretreatment (baseline) and failure samples from participants with virologic failure.
RESULTS: HIV genotyping results were obtained for 211/249 participants (128 early ART arm and 83 delayed ART arm) with virologic failure. Drug resistance was detected in 4.7% of participants at baseline; 35.5% had new resistance at failure. In univariate analysis, the frequency of new resistance at failure was lower among participants in the early ART arm (compared with delayed ART arm, P = 0.06; compared with delayed ART arm with ART initiation before May 2011, P = 0.032). In multivariate analysis, higher baseline viral load (P = 0.0008) and ART regimen (efavirenz/lamivudine/zidovudine compared with other regimens, P = 0.024) were independently associated with higher risk of new resistance at failure.
CONCLUSIONS: In HPTN 052, the frequency of new drug resistance at virologic failure was lower in adults with early ART initiation. The main factor associated with reduced drug resistance with early ART was lower baseline viral load.