艾滋病毒耐药性
抗药性
医学
队列
人类免疫缺陷病毒(HIV)
队列研究
内科学
药品
慢病毒
病毒性疾病
病毒载量
病毒学
抗逆转录病毒疗法
生物
药理学
微生物学
作者
Jessica M. Fogel,Mariya V. Sivay,Vanessa Cummings,Ethan Wilson,Stephen A. Hart,Theresa Gamble,Oliver Laeyendecker,Reinaldo E. Fernández,Carlos del Rı́o,D. Scott Batey,Kenneth H. Mayer,Jason E. Farley,Laura McKinstry,James P. Hughes,Robert H. Remien,Chris Beyrer,Susan H. Eshleman
出处
期刊:AIDS
[Ovid Technologies (Wolters Kluwer)]
日期:2020-01-01
卷期号:34 (1): 91-101
被引量:16
标识
DOI:10.1097/qad.0000000000002394
摘要
Objective: To analyze HIV drug resistance among MSM recruited for participation in the HPTN 078 study, which evaluated methods for achieving and maintaining viral suppression in HIV-infected MSM. Methods: Individuals were recruited at four study sites in the United States (Atlanta, Georgia; Baltimore, Maryland; Birmingham, Alabama; and Boston, Massachusetts; 2016–2017). HIV genotyping was performed using samples collected at study screening or enrollment. HIV drug resistance was evaluated using the Stanford v8.7 algorithm. A multiassay algorithm was used to identify individuals with recent HIV infection. Clustering of HIV sequences was evaluated using phylogenetic methods. Results: High-level HIV drug resistance was detected in 44 (31%) of 142 individuals (Atlanta: 21%, Baltimore: 29%, Birmingham: 53%, Boston: 26%); 12% had multiclass resistance, 16% had resistance to tenofovir or emtricitabine, and 8% had resistance to integrase strand transfer inhibitors (INSTIs); 3% had intermediate-level resistance to second-generation INSTIs. In a multivariate model, self-report of ever having been on antiretroviral therapy (ART) was associated with resistance (P = 0.005). One of six recently infected individuals had drug resistance. Phylogenetic analysis identified five clusters of study sequences; two clusters had shared resistance mutations. Conclusion: High prevalence of drug resistance was observed among MSM. Some had multiclass resistance, resistance to drugs used for preexposure prophylaxis (PrEP), and INSTI resistance. These findings highlight the need for improved HIV care in this high-risk population, identification of alternative regimens for PrEP, and inclusion of integrase resistance testing when selecting ART regimens for MSM in the United States.
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