PMID- 22473024
OWN - NLM
STAT- MEDLINE
DCOM- 20130115
LR  - 20220129
IS  - 2040-2058 (Electronic)
IS  - 1359-6535 (Linking)
VI  - 17
IP  - 5
DP  - 2012
TI  - HIV-1 drug resistance in antiretroviral-naive individuals with HIV-1-associated 
      tuberculous meningitis initiating antiretroviral therapy in Vietnam.
PG  - 905-13
LID - 10.3851/IMP2092 [doi]
AB  - BACKGROUND: Access to antiretroviral therapy (ART) for HIV-infected individuals 
      in Vietnam is rapidly expanding, but there are limited data on HIV drug 
      resistance (HIVDR) to guide ART strategies. METHODS: We retrospectively conducted 
      HIVDR testing in 220 ART-naive individuals recruited to a randomized controlled 
      trial of immediate versus deferred ART in individuals with HIV-associated 
      tuberculous meningitis in Ho Chi Minh City (HCMC) from 2005-2008. HIVDR mutations 
      were identified by population sequencing of the HIV pol gene and were defined 
      based on 2009 WHO surveillance drug resistance mutations (SDRMs). RESULTS: We 
      successfully sequenced 219/220 plasma samples of subjects prior to ART; 218 were 
      subtype CRF01_AE and 1 was subtype B. SDRMs were identified in 14/219 (6.4%) 
      subjects; 8/14 were resistant to nucleoside/nucleotide reverse transcriptase 
      inhibitors (NRTIs; T69D, L74V, V75M, M184V/I and K219R), 5/14 to non-nucleoside 
      reverse transcriptase inhibitors (NNRTIs; K103N, V106M, Y181C, Y188C and G190A), 
      1/14 to both NRTIs and NNRTIs (D67N and Y181C) and none to protease inhibitors. 
      After 6 months of ART, eight subjects developed protocol-defined virological 
      failure. HIVDR mutations were identified in 5/8 subjects. All five had mutations 
      with high-level resistance to NNRTIs and three had mutations with high-level 
      resistance to NRTIs. Due to a high early mortality rate (58%), the effect of 
      pre-existing HIVDR mutations on treatment outcome could not be accurately 
      assessed. CONCLUSIONS: The prevalence of WHO SDRMs in ART-naive individuals with 
      HIV-associated tuberculous meningitis in HCMC from 2005-2008 is 6.4%. The SDRMs 
      identified conferred resistance to NRTIs and/or NNRTIs, reflecting the standard 
      first-line ART regimens in Vietnam.
FAU - Thao, Vu P
AU  - Thao VP
AD  - Wellcome Trust Major Overseas Programme, Oxford University Clinical Research 
      Unit, Ho Chi Minh City, Vietnam.
FAU - Le, Thuy
AU  - Le T
FAU - Torok, Estee M
AU  - Torok EM
FAU - Yen, Nguyen T B
AU  - Yen NT
FAU - Chau, Tran T H
AU  - Chau TT
FAU - Jurriaans, Suzanne
AU  - Jurriaans S
FAU - van Doorn, H Rogier
AU  - van Doorn HR
FAU - de Jong, Menno D
AU  - de Jong MD
FAU - Farrar, Jeremy J
AU  - Farrar JJ
FAU - Dunstan, Sarah J
AU  - Dunstan SJ
LA  - eng
GR  - G1100682/MRC_/Medical Research Council/United Kingdom
GR  - WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120321
PL  - England
TA  - Antivir Ther
JT  - Antiviral therapy
JID - 9815705
RN  - 0 (Anti-HIV Agents)
SB  - IM
EIN - Antivir Ther. 2012;17(5):937. van Doorn, Rogier H [corrected to van Doorn, H 
      Rogier]
MH  - Anti-HIV Agents/pharmacology/therapeutic use
MH  - Coinfection/drug therapy
MH  - *Drug Resistance, Viral/genetics
MH  - Genotype
MH  - HIV Infections/complications/*drug therapy/virology
MH  - HIV-1/drug effects/*genetics
MH  - Humans
MH  - Mutation
MH  - Polymorphism, Genetic
MH  - Prevalence
MH  - Treatment Failure
MH  - Tuberculosis, Meningeal/*complications
MH  - Vietnam/epidemiology
EDAT- 2012/04/05 06:00
MHDA- 2013/01/16 06:00
CRDT- 2012/04/05 06:00
PHST- 2011/10/10 00:00 [accepted]
PHST- 2012/04/05 06:00 [entrez]
PHST- 2012/04/05 06:00 [pubmed]
PHST- 2013/01/16 06:00 [medline]
AID - 10.3851/IMP2092 [doi]
PST - ppublish
SO  - Antivir Ther. 2012;17(5):905-13. doi: 10.3851/IMP2092. Epub 2012 Mar 21.