Trends in Decline of Antiretroviral Resistance among ARV-Experienced Patients in the HIV Outpatient Study: 1999–2008. (14th March 2012)

• Record Type: Journal Article
• Authors: Buchacz, Kate; Baker, Rose; Ward, Douglas J.; Palella, Frank J.; Chmiel, Joan S.; Young, Benjamin; Yangco, Bienvenido G.; Novak, Richard M.; Brooks, John T.
• Other Names: Diaz Ricardo Sobhie Academic Editor.
• Is Part Of: AIDS research and treatment. Volume 2012(2012)
• Publication Date: 2012-03-14
• Subjects: AIDS (Disease) -- Periodicals; AIDS (Disease) -- Research -- Periodicals; AIDS (Disease) -- Treatment -- Periodicals; AIDS (Disease) -- Patients -- Care -- Periodicals; AIDS (Disease) -- Patients -- Services for -- Periodicals; 616.979205
• DOI: 10.1155/2012/230290
• Languages: English
• ISSNs: 2090-1240

Abstract

Abstract : Background . Little is known about temporal trends in frequencies of clinically relevant ARV resistance mutations in HIV strains from U.S. patients undergoing genotypic testing (GT) in routine HIV care. Methods . We analyzed cumulative frequency of HIV resistance among patients in the HIV Outpatient Study (HOPS) who, during 1999–2008 and while prescribed antiretrovirals, underwent GT with plasma HIV RNA >1, 000 copies/mL. Exposure ≥4 months to each of three major antiretroviral classes (NRTI, NNRTI and PI) was defined as triple-class exposure (TCE). Results . 906 patients contributed 1, 570 GT results. The annual frequency of any major resistance mutations decreased during 1999–2008 (88% to 79%, P = 0.05 ). Resistance to PIs decreased among PI-exposed patients (71% to 46%, P = 0.010 ) as exposure to ritonavir-boosted PIs increased (6% to 81%, P < 0.001 ). Non-significant declines were observed in resistance to NRTIs among NRTI-exposed (82% to 67%), and triple-class-resistance among TCE patients (66% to 41%), but not to NNRTIs among NNRTI-exposed. Conclusions. HIV resistance was common but declined in HIV isolates from subgroups of ARV-experienced HOPS patients during 1999–2008. Resistance to PIs among PI-exposed patients decreased, possibly due to increased representation of patients whose only PI exposures were to boosted PIs.