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Global epidemiology of drug resistance after failure of WHO recommended first-line regimens for adult HIV-1 infection: a multicentre retrospective cohort study.

- Lancet Infect Dis (2016)

Bottom Line: 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 count <100 cells per μL).Effective surveillance for transmission of drug resistance is crucial.The Wellcome Trust.

View Article: PubMed Central - PubMed

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Related in: MedlinePlus

Pooled odds ratios for tenofovir resistance after viral failure for baseline CD4 cell count <100 vs ≥100 × 106 cells per μLTDF+ denotes presence of tenofovir resistance. TDF=tenofovir disoproxil fumarate.
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fig2: Pooled odds ratios for tenofovir resistance after viral failure for baseline CD4 cell count <100 vs ≥100 × 106 cells per μLTDF+ denotes presence of tenofovir resistance. TDF=tenofovir disoproxil fumarate.

Mentions: Low baseline CD4 cell count was consistently associated with a higher prevalence of tenofovir resistance across regions. The pooled OR for tenofovir in individuals with a CD4 cell count of less than 100 cells per μL versus 100  cells per μL was 1·50 (95% CI 1·27–1·77; figure 2). By contrast, a high baseline viral load was only associated with a small, not significant increase in tenofovir resistance (OR for viral load ≥100 000 copies per mL vs <100 000 copies per mL was 1·17, 95% CI 0·94–1·44; appendix). We compared tenofovir resistance by use of co-administered antiretrovirals with tenofovir as first-line therapy. Use of lamivudine rather than emtricitabine (NRTIs) was associated with a higher prevalence of tenofovir resistance (OR 1·48, 95% CI 1·20–1·82), as was use of the NNRTI nevirapine rather than efavirenz (OR 1·46, 1·28–1·67; appendix). Subgroup analysis showed that as well as associations being consistent across regions, they were also generally similar across a range of study settings (appendix), although there was some evidence of a greater effect size of baseline CD4 when efavirenz was co-administered with tenofovir, as compared with nevirapine.


Global epidemiology of drug resistance after failure of WHO recommended first-line regimens for adult HIV-1 infection: a multicentre retrospective cohort study.

- Lancet Infect Dis (2016)

Pooled odds ratios for tenofovir resistance after viral failure for baseline CD4 cell count <100 vs ≥100 × 106 cells per μLTDF+ denotes presence of tenofovir resistance. TDF=tenofovir disoproxil fumarate.
© Copyright Policy - CC BY
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835583&req=5

fig2: Pooled odds ratios for tenofovir resistance after viral failure for baseline CD4 cell count <100 vs ≥100 × 106 cells per μLTDF+ denotes presence of tenofovir resistance. TDF=tenofovir disoproxil fumarate.
Mentions: Low baseline CD4 cell count was consistently associated with a higher prevalence of tenofovir resistance across regions. The pooled OR for tenofovir in individuals with a CD4 cell count of less than 100 cells per μL versus 100  cells per μL was 1·50 (95% CI 1·27–1·77; figure 2). By contrast, a high baseline viral load was only associated with a small, not significant increase in tenofovir resistance (OR for viral load ≥100 000 copies per mL vs <100 000 copies per mL was 1·17, 95% CI 0·94–1·44; appendix). We compared tenofovir resistance by use of co-administered antiretrovirals with tenofovir as first-line therapy. Use of lamivudine rather than emtricitabine (NRTIs) was associated with a higher prevalence of tenofovir resistance (OR 1·48, 95% CI 1·20–1·82), as was use of the NNRTI nevirapine rather than efavirenz (OR 1·46, 1·28–1·67; appendix). Subgroup analysis showed that as well as associations being consistent across regions, they were also generally similar across a range of study settings (appendix), although there was some evidence of a greater effect size of baseline CD4 when efavirenz was co-administered with tenofovir, as compared with nevirapine.

Bottom Line: 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 count <100 cells per μL).Effective surveillance for transmission of drug resistance is crucial.The Wellcome Trust.

View Article: PubMed Central - PubMed

No MeSH data available.


Related in: MedlinePlus