The efficacy of first-line ART regimens based on RPV in HIV-infected patients with pre-existing E138A mutation in reverse transcriptase

Mapping Intimacies ◽

10.21203/rs.3.rs-402978/v1 ◽

2021 ◽

Author(s):

Anna Kuznetsova ◽

Aleksey Lebedev ◽

Konstantin Gromov ◽

Elena Kazennova ◽

Maurizio Zazzi ◽

...

Keyword(s):

Viral Load ◽

Reverse Transcriptase ◽

Clinical Decisions ◽

First Line ◽

Viral Load Data ◽

Lack Of Knowledge

Abstract Introduction It was previously shown that the presence of the E138A mutation is associated with resistance to rilpivirine (RPV). Detection of this mutation is considered as contraindication for RPV use within the first-line ART. It is a lack of knowledge regarding efficacy of first-line RPV-based ART in patients bearing HIV with E138A mutation. In absence of HIV genotyping in naïve patients it may influence the clinical decisions.Methods We have collected all available patients unconventionally treated with RPV and carefully analyzed the ART efficacy in E138A carriers from the EuResist database. The viral load data in patients with E138A mutation at baseline was extracted from the database. Due to uniqueness of these cases only 11 HIV infected patients were found. The virologic outcome was analyzed according to the national and international ART guidelines.Results The full virologic efficacy of the first-line RPV-based ART regimen was demonstrated in 11 out of 11 patients according to all guidelines.Conclusions Our data suggest that the influence of the pre-existing E138A mutation on the sensitivity to RPV is very low or insignificant. The results support importance of investigation of polymorphic pre-existing HIV drug mutations for ART efficacy.

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First-line antiretroviral therapy with a protease inhibitor versus non-nucleoside reverse transcriptase inhibitor and switch at higher versus low viral load in HIV-infected children: an open-label, randomised phase 2/3 trial

The Lancet Infectious Diseases ◽

10.1016/s1473-3099(10)70313-3 ◽

2011 ◽

Vol 11 (4) ◽

pp. 273-283 ◽

Cited By ~ 88

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Protease Inhibitor ◽

Reverse Transcriptase ◽

Nucleoside Reverse Transcriptase Inhibitor ◽

Transcriptase Inhibitor ◽

Phase 2 ◽

First Line ◽

Open Label ◽

Reverse Transcriptase Inhibitor

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Level of viral load and antiretroviral resistance after 6 months of non-nucleoside reverse transcriptase inhibitor first-line treatment in HIV-1-infected children in Mali

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkp412 ◽

2009 ◽

Vol 65 (1) ◽

pp. 118-124 ◽

Cited By ~ 38

Author(s):

D. Germanaud ◽

A. Derache ◽

M. Traore ◽

Y. Madec ◽

S. Toure ◽

...

Keyword(s):

Viral Load ◽

Reverse Transcriptase ◽

Nucleoside Reverse Transcriptase Inhibitor ◽

Transcriptase Inhibitor ◽

Line Treatment ◽

First Line ◽

Antiretroviral Resistance ◽

Reverse Transcriptase Inhibitor ◽

Hiv 1 ◽

First Line Treatment

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P17 Response of individuals with high viral load to non-nucleoside reverse transcriptase inhibitors

HIV Medicine ◽

10.1046/j.1468-1293.2000.00024-81.x ◽

2000 ◽

Vol 1 (3) ◽

pp. 178-178

Author(s):

M Nelson ◽

A Shaw ◽

R Baker ◽

M Bower ◽

M Fisher ◽

...

Keyword(s):

Viral Load ◽

Reverse Transcriptase ◽

High Viral Load ◽

Reverse Transcriptase Inhibitors ◽

Nucleoside Reverse Transcriptase Inhibitors

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Estimation of the incubation period of COVID-19 using viral load data

Epidemics ◽

10.1016/j.epidem.2021.100454 ◽

2021 ◽

pp. 100454

Author(s):

Keisuke Ejima ◽

Kwang Su Kim ◽

Christina Ludema ◽

Ana I. Bento ◽

Shoya Iwanami ◽

...

Keyword(s):

Viral Load ◽

Incubation Period ◽

Viral Load Data

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Adapting the role of handheld echocardiography during the COVID-19 pandemic: A practical guide

Perfusion ◽

10.1177/0267659120986532 ◽

2021 ◽

pp. 026765912098653

Author(s):

Hafiz Naderi ◽

Shaun Robinson ◽

Martin J Swaans ◽

Nina Bual ◽

Wing-See Cheung ◽

...

Keyword(s):

Viral Load ◽

Potential Role ◽

Assessment Tool ◽

High Viral Load ◽

First Line ◽

Scanning Time ◽

Contagious Disease ◽

Core Dataset ◽

Clinical Questions

The COVID-19 pandemic has altered our approach to inpatient echocardiography delivery. There is now a greater focus to address key clinical questions likely to make an immediate impact in management, particularly during the period of widespread infection. Handheld echocardiography (HHE) can be used as a first-line assessment tool, limiting scanning time and exposure to high viral load. This article describes a potential role for HHE during a pandemic. We propose a protocol with a reporting template for a focused core dataset necessary in delivering an acute echocardiography service in the setting of a highly contagious disease, minimising risk to the operator. We cover the scenarios typically encountered in the acute cardiology setting and how an expert trained echocardiography team can identify such pathologies using a limited imaging format and include cardiac presentations encountered in those patients acutely unwell with COVID-19.

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Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

AIDS Research and Therapy ◽

10.1186/s12981-021-00336-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Anita Mesic ◽

Alexander Spina ◽

Htay Thet Mar ◽

Phone Thit ◽

Tom Decroo ◽

...

Keyword(s):

Viral Load ◽

Virological Failure ◽

Antiretroviral Treatment ◽

People Living With Hiv ◽

First Line ◽

Hiv Viral Load ◽

Loss To Follow Up ◽

History Of ◽

Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

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