PMID- 27074792
OWN - NLM
STAT- MEDLINE
DCOM- 20170630
LR  - 20180105
IS  - 1758-1052 (Electronic)
IS  - 0956-4624 (Linking)
VI  - 27
IP  - 14
DP  - 2016 Dec
TI  - An unusual case of underlying rilpivirine resistance in an antiretroviral-naive 
      man with AIDS.
PG  - 1346-1349
AB  - Primary resistance mutations to second generation HIV non-nucleoside reverse 
      transcriptase inhibitors are rare in HIV-infected persons in the US (estimated at 
      1.8%). We report an antiretroviral treatment (ART)-naive patient with acquired 
      immunodeficiency syndrome (AIDS) (CD4 cell count 20 cells/mm(3), viral load 8439 
      copies/mL), who was infected with HIV-1 sub-type B virus containing a reverse 
      transcriptase mutation, E138A, associated with rilpivirine resistance. 
      Subsequently, he was initiated on a single tablet ART regimen containing an 
      integrase inhibitor and developed immune reconstitution inflammatory syndrome 
      (IRIS), presenting as Mycobacterium avium cervical adenitis. The patient went on 
      to develop rifamycin-induced neutropenia during treatment of his opportunistic 
      infection but later recovered his counts, and remains well on an integrase-based 
      HIV regimen. His case illustrates the growing importance of archived resistance 
      mutations including the less common E138A mutation, as well as the risk and rapid 
      occurrence of IRIS in AIDS patients initiated on integrase inhibitors.
CI  - (c) The Author(s) 2016.
FAU - Skalweit, Marion J
AU  - Skalweit MJ
AD  - Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, 
      OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA 
      marion.skalweit@va.gov.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20160412
PL  - England
TA  - Int J STD AIDS
JT  - International journal of STD & AIDS
JID - 9007917
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Integrase Inhibitors)
RN  - 0 (Reverse Transcriptase Inhibitors)
RN  - EC 2.7.7.- (reverse transcriptase, Human immunodeficiency virus 1)
RN  - EC 2.7.7.49 (HIV Reverse Transcriptase)
RN  - FI96A8X663 (Rilpivirine)
SB  - IM
MH  - Acquired Immunodeficiency Syndrome/*drug therapy
MH  - Anti-HIV Agents/*therapeutic use
MH  - CD4 Lymphocyte Count
MH  - Drug Resistance, Viral/*genetics
MH  - HIV Infections/drug therapy/virology
MH  - HIV Reverse Transcriptase/*genetics
MH  - HIV-1/*drug effects/genetics
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*complications/drug therapy
MH  - Integrase Inhibitors/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Mutation
MH  - Reverse Transcriptase Inhibitors/therapeutic use
MH  - Rilpivirine/*therapeutic use
MH  - Treatment Outcome
MH  - Tuberculosis/*complications
OTO - NOTNLM
OT  - AIDS
OT  - HIV
OT  - Mycobacterium avium cervical adenitis
OT  - immune reconstitution inflammatory syndrome
OT  - non-nucleoside reverse transcriptase inhibitors
OT  - primary resistance
OT  - rilpivirine
OT  - treatment
EDAT- 2016/04/15 06:00
MHDA- 2017/07/01 06:00
CRDT- 2016/04/15 06:00
PHST- 2015/12/08 00:00 [received]
PHST- 2016/03/09 00:00 [accepted]
PHST- 2016/04/15 06:00 [pubmed]
PHST- 2017/07/01 06:00 [medline]
PHST- 2016/04/15 06:00 [entrez]
AID - 0956462416643852 [pii]
AID - 10.1177/0956462416643852 [doi]
PST - ppublish
SO  - Int J STD AIDS. 2016 Dec;27(14):1346-1349. doi: 10.1177/0956462416643852. Epub 
      2016 Apr 12.