Prevalence of etravirine (ETR)‐RAMs at NNRTI failure and predictors of resistance to ETR in a large Italian resistance database (ARCA)1. (26th April 2013)

• Record Type: Journal Article
• Authors: Rusconi, S.; Adorni, F.; Bruzzone, B.; Di Biagio, A.; Meini, G.; Callegaro, A.; Punzi, G.; Boeri, E.; Pecorari, M.; Monno, L.; Gianotti, N.; Butini, L.; Galli, L.; Polilli, E.; Galli, M.
• Editors: Antonelli, G.
• Is Part Of: Clinical microbiology and infection. Volume 19:Number 10(2013:Oct.)
• Page Start: E443
• Page End: E446
• Publication Date: 2013-04-26
• Subjects: Drug resistance -- etravirine -- genotype -- HIV‐1; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/1469-0691.12229
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: The prevalence of drug resistance associated with the failure of non‐nucleoside reverse transcriptase inhibitor (NNRTI)‐based regimens and the predictors of resistance to Etravirine (ETR) were assessed in 2854 subjects: 39 < 18 (paediatric) and 2815 ≥ 18 (adult) years old. These subjects failed to respond to their current NNRTI treatment, were three‐class experienced and had been exposed to NNRTI for ≥3 months. A total of 1827 adult (64.9%) and 32 paediatric subjects (82.1%) harboured the virus with at least one ETR mutation. V179I, Y181C and G190A were the most frequent mutations in both groups. A significantly increased risk of ETR resistance with all three algorithms (Monogram (MGR) >3, Tibotec (TBT) >2 and enhanced MGR (ENH) ≥4) emerged in the paediatric population. Multivariate analysis revealed an increased risk of developing TBT >2 for NNRTI exposure, ENH ≥4 for NNRTI and EFV exposure in paediatric subjects; NVP exposure and higher (≥3.5 log10) HIV‐RNA values for all three algorithms in adult subjects, whereas CD4 ≥ 200/μL appeared to be protective. The risk of being ETR resistant was more than doubled for paediatric vs. adult subjects, probably due to a more extensive use of NNRTI and an incomplete virological control.