Detection of drug resistance mutations at low plasma HIV-1 RNA load in a European multicentre cohort study

Salvatrice Mancuso, Loveleen Bansi, Iuri Fanti, Mattia C.F. Prosperi, Kristel Van Laethem, Rolf Kaiser, David A.M.C. Van De Vijver, Ricardo Camacho, Simona Di Giambenedetto, Anna Maria Geretti, Nicola Mackie, Carlo Torti, Maurizio Zazzi, Anders Sönnerborg, Andrea De Luca, Francisco M. Codoñer, Ricardo Camacho

Risultato della ricerca: Articlepeer review

34 Citazioni (Scopus)

Abstract

Background and objectives: Guidelines indicate a plasma HIV-1 RNA load of 500-1000 copies/mL as the minimal threshold for antiretroviral drug resistance testing. Resistance testing at lower viral load levels may be useful to guide timely treatment switches, although data on the clinical utility of this remain limited. We report here the influence of viral load levels on the probability of detecting drug resistance mutations (DRMs) and other mutations by routine genotypic testing in a large multicentre European cohort, with a focus on tests performed at a viral load <1000 copies/mL. Methods: A total of 16511 HIV-1 reverse transcriptase and protease sequences from 11492 treatment-experienced patients were identified, and linked to clinical data on viral load, CD4 T cell counts and antiretroviral treatment history. Test results from 3162 treatment-naive patients served as controls. Multivariable analysis was employed to identify predictors of reverse transcriptase and protease DRMs. Results: Overall, 2500/16 511 (15.14%) test results were obtained at a viral load <1000 copies/mL. Individuals with viral load levels of 1000-10000 copies/mL showed the highest probability of drug resistance to any drug class. Independently from other measurable confounders, treatment-experienced patients showed a trend for DRMs and other mutations to decrease at viral load levels <500 copies/mL. Conclusions: Genotypic testing at low viral load may identify emerging antiretroviral drug resistance at an early stage, and thus might be successfully employed in guiding prompt management strategies that may reduce the accumulation of resistance and cross-resistance, viral adaptive changes, and larger viral load increases. © The Author 2011. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Lingua originaleEnglish
pagine (da-a)1886-1896
Numero di pagine11
RivistaJournal of Antimicrobial Chemotherapy
Volume66
Stato di pubblicazionePublished - 2011

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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