Continuation of emtricitabine/lamivudine within combination antiretroviral therapy following detection of the M184V/I HIV‐1 resistance mutation. Issue 5 (11th January 2020)

• Record Type: Journal Article
• Authors: Stirrup, OT; Asboe, D; Pozniak, A; Sabin, CA; Gilson, R; Mackie, NE; Tostevin, A; Hill, T; Dunn, DT
• Other Names: Chadwick David investigator.; Churchill Duncan investigator.; Clark Duncan investigator.; Collins Simon investigator.; Delpech Valerie investigator.; Douthwaite Samuel investigator.; Fearnhill Esther investigator.; Porter Kholoud investigator.; Fraser Christophe investigator.; Geretti Anna Maria investigator.; Gunson Rory investigator.; Hale Antony investigator.; Hué Stéphane investigator.; Lazarus Linda investigator.; Leigh‐Brown Andrew investigator.; Mbisa Tamyo investigator.; Orkin Chloe investigator.; Nastouli Eleni investigator.; Pillay Deenan investigator.; Phillips Andrew investigator.; Smit Erasmus investigator.; Templeton Kate investigator.; Tilston Peter investigator.; Volz Erik investigator.; Williams Ian investigator.; Zhang Hongyi investigator.; Fairbrother Keith investigator.; Dawkins Justine investigator.; O'Shea Siobhan investigator.; Mullen Jane investigator.; Cox Alison investigator.; Tandy Richard investigator.; Fawcett Tracy investigator.; Hopkins Mark investigator.; Booth Clare investigator.; Garcia‐Diaz Ana investigator.; Renwick Lynne investigator.; Schmid Matthias L. investigator.; Payne Brendan investigator.; Hubb Jonathan investigator.; Dustan Simon investigator.; Kirk Stuart investigator.; Bradley‐Stewart Amanda investigator.; Ainsworth Jonathan investigator.; Allan Sris investigator.; Anderson Jane investigator.; Apoola Ade investigator.; Fairley Ian investigator.; Fox Ashini investigator.; Gompels Mark investigator.; Hay Phillip investigator.; Hembrom Rajesh investigator.; Johnson Margaret investigator.; Jose Sophie investigator.; Kegg Stephen investigator.; Leen Clifford investigator.; Mital Dushyant investigator.; Nelson Mark investigator.; Okhai Hajra investigator.; Palfreeman Adrian investigator.; Price Ashley investigator.; Post Frank investigator.; Pritchard Jillian investigator.; Schwenk Achim investigator.; Tariq Anjum investigator.; Trevelion Roy investigator.; Ustianowski Andy investigator.; Walsh John investigator.; van Looy Nadine investigator.; Lynch Janet investigator.; Hand James investigator.; Tilbury Stuart investigator.; Youssef Elaney investigator.; Daly Richard investigator.; Mandalia Sundhiya investigator.; Munshi Sajid investigator.; Adefisan Ade investigator.; Taylor Chris investigator.; Gleisner Zachary investigator.; Ibrahim Fowzia investigator.; Campbell Lucy investigator.; Baillie Kirsty investigator.; Miller Sheila investigator.; Wood Chris investigator.; Youle Mike investigator.; Mackie Nicky investigator.; Winston Alan investigator.; Weber Jonathan investigator.; Ramzan Farhan investigator.; Carder Mark investigator.; Kerr Andrew investigator.; Wilks David investigator.; Morris Sheila investigator.; Allan Sue investigator.; Lewszuk Adam investigator.; Ogunbiyi Victoria investigator.; Mitchell Sue investigator.; Hunt Christopher investigator.; Okolo Olanike investigator.; Watts Benjamin investigator.; Russell‐Sharpe Sarah investigator.; Fagbayimu Olatunde investigator.; Brain Debra investigator.; Radford Liz investigator.; Milgate Sarah investigator.; Cumming Shirley investigator.; Atkinson Claire investigator.; Rose Annie investigator.; Smith Jeanette investigator.; Murphy Cynthia investigator.; Gunder Ilise investigator.; Gees Howard investigator.; Squires Gemma investigator.; Anderson Laura investigator.; Mansfield Serena investigator.; Tomlinson Lee investigator.; LeHegerat Christine investigator.; Box Roberta investigator.; Hatton Tom investigator.; Herbert Doreen investigator.; McVittie Ian investigator.; Murtha Victoria investigator.; Shewan Laura investigator.; Connan Zak investigator.; Gregory Luke investigator.; Holding Kathleen investigator.; Chester Victoria investigator.; Mistry Trusha investigator.; Gatford Catherine investigator.;
• Is Part Of: HIV medicine. Volume 21:Issue 5(2020)
• Page Start: 309
• Page End: 321
• Publication Date: 2020-01-11
• Subjects: emtricitabine -- HIV -- lamivudine -- M184I -- M184V; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12829
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: The aim of the study was to investigate whether lamivudine (3TC) or emtricitabine (FTC) use following detection of M184V/I is associated with better virological outcomes. Methods: We identified people with viruses harbouring the M184V/I mutation in UK multicentre data sets who had treatment change/initiation within 1 year. We analysed outcomes of viral suppression (< 200 HIV‐1 RNA copies/mL) and appearance of new major drug resistance mutations (DRMs) using Cox and Poisson models, with stratification by new drug regimen (excluding 3TC/FTC) and Bayesian implementation, and estimated the effect of 3TC/FTC adjusted for individual and viral characteristics. Results: We included 2597 people with the M184V/I resistance mutation, of whom 665 (25.6%) were on 3TC and 458 (17.6%) on FTC. We found a negative adjusted association between 3TC/FTC use and viral suppression [hazard ratio (HR) 0.84; 95% credibility interval (CrI) 0.71–0.98]. On subgroup analysis of individual drugs, there was no evidence of an association with viral suppression for 3TC ( n = 184; HR 0.94; 95% CrI 0.73–1.15) or FTC ( n = 454; HR 0.99; 95% CrI 0.80–1.19) amongst those on tenofovir‐containing regimens, but we estimated a reduced rate of viral suppression for people on 3TC amongst those without tenofovir use ( n = 481; HR 0.71; 95% CrI 0.54–0.90). We found no association between 3TC/FTC and detection of any new DRM (overall HR 0.92; 95% CrI 0.64–1.18), but found inconclusive evidence of a lower incidence rate of new DRMs (overall incidence rate ratio 0.69; 95% CrI 0.34–1.11). Conclusions: We did not find evidence that 3TC or FTC use is associated with an increase in viral suppression, but it may reduce the appearance of additional DRMs in people with M184V/I. 3TC was associated with reduced viral suppression amongst people on regimens without tenofovir.