Pre-treatment minority HIV-1 drug resistance mutations and long term virological outcomes: is prediction possible?
| dc.contributor.author | Mzingwane, M.L. | |
| dc.contributor.author | Tiemessen, C.T. | |
| dc.contributor.author | Richter, K.L. | |
| dc.contributor.author | Mayaphi, S.H. | |
| dc.contributor.author | Hunt, G. | |
| dc.contributor.author | Bowyer, S.M. | |
| dc.date.accessioned | 2017-01-04T13:30:26Z | |
| dc.date.accessioned | 2023-06-29T09:43:21Z | |
| dc.date.available | 2017-01-04T13:30:26Z | |
| dc.date.available | 2023-06-29T09:43:21Z | |
| dc.date.issued | 2016-10-12 | |
| dc.description | This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | en_US |
| dc.description.abstract | Background: Although the use of highly active antiretroviral therapy in HIV positive individuals has proved to be effective in suppressing the virus to below detection limits of commonly used assays, virological failure associated with drug resistance is still a major challenge in some settings. The prevalence and effect of pre-treatment resistance associated variants on virological outcomes may also be underestimated because of reliance on conventional population sequencing data which excludes minority species. We investigated long term virological outcomes and the prevalence and pattern of pre-treatment minority drug resistance mutations in individuals initiating HAART at a local HIV clinic. Methods: Patient’s records of viral load results and CD4 cell counts from routine treatment monitoring were used and additional pre-treatment blood samples for Sanger sequencing were obtained. A selection of pretreatment samples from individuals who experienced virological failure were evaluated for minority resistance associated mutations to 1 % prevalence and compared to individuals who achieved viral suppression. Results: At least one viral load result after 6 months or more of treatment was available for 65 out of 78 individuals followed for up to 33 months. Twenty (30.8 %) of the 65 individuals had detectable viremia and eight (12.3 %) of them had virological failure (viral load > 1000 RNA copies/ml) after at least 6 months of HAART. Viral suppression, achieved by month 8 to month 13, was followed by low level viremia in 10.8 % of patients and virological failure in one patient after month 20. There was potentially reduced activity to Emtricitabine or Tenofovir in three out of the eight cases in which minority drug resistance associated variants were investigated but detectable viremia occurred in one of these cases while the activity of Efavirenz was generally reduced in all the eight cases. Conclusions: Early viral suppression was followed by low level viremia for some patients which may be an indication of failure to sustain viral suppression over time. The low level viremia may also be representing early stages of resistance development. The mutation patterns detected in the minority variants showed potential reduced drug sensitivity which highlights their potential to dominate after treatment initiation. | en_US |
| dc.description.sponsorship | This work is based on the research supported by grants awards from South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation of South Africa (C.T. Tiemessen), the HIV Research Trust (M.L. Mzingwane), the National Health Laboratory Service Research Trust and the Poliomyelitis Research Foundation. | en_US |
| dc.identifier.citation | Mzingwane, M.L., Tiemessen, C.T., Richter, K.L., Mayaphi, S.H., Hunt, G. and Bowyer, S.M. (2016) ‘Pre-treatment minority HIV-1 drug resistance mutations and long term virological outcomes: Is prediction possible?’, Virology Journal, 13(1). doi: 10.1186/s12985-016-0628-x. | en_US |
| dc.identifier.issn | 1743-422x | |
| dc.identifier.uri | http://196.220.97.103:4000/handle/123456789/781 | |
| dc.language.iso | en | en_US |
| dc.publisher | BioMed Central | en_US |
| dc.subject | HIV | en_US |
| dc.subject | Virological outcomes | en_US |
| dc.subject | Drug resistance | en_US |
| dc.subject | Minority variants | en_US |
| dc.title | Pre-treatment minority HIV-1 drug resistance mutations and long term virological outcomes: is prediction possible? | en_US |
| dc.type | Article | en_US |