No Evidence That HIV-1 Subtype C Infection Compromises the Efficacy of Tenofovir-Containing Regimens: Cohort Study in the United Kingdom. (24th May 2016)

• Record Type: Journal Article
• Authors: White, Ellen; Smit, Erasmus; Churchill, Duncan; Collins, Simon; Booth, Clare; Tostevin, Anna; Sabin, Caroline; Pillay, Deenan; Dunn, David T.; Aitken, Celia; Asboe, David; Pozniak, Anton; Cane, Patricia; Chadwick, David; Churchill, Duncan; Clark, Duncan; Collins, Simon; Delpech, Valerie; Douthwaite, Samuel; Dunn, David; Fearnhill, Esther; Porter, Kholoud; Tostevin, Anna; White, Ellen; Fraser, Christophe; Geretti, Anna Maria; Hale, Antony; Hué, Stéphane; Kaye, Steve; Kellam, Paul; Lazarus, Linda; Leigh-Brown, Andrew; Mbisa, Tamyo; Mackie, Nicola; Moses, Samuel; Orkin, Chloe; Nastouli, Eleni; Pillay, Deenan; Phillips, Andrew; Sabin, Caroline; Smit, Erasmus; Templeton, Kate; Tilston, Peter; Williams, Ian; Zhang, Hongyi; Fairbrother, Keith; Greatorex, Jane; O'Shea, Siobhan; Mullen, Jane; Smit, Erasmus; Mbisa, Tamyo; Cox, Alison; Tandy, Richard; Fawcett, Tracy; Hopkins, Mark; Ashton, Lynn; Booth, Clare; Garcia-Diaz, Ana; Shepherd, Jill; Schmid, Matthias L.; Payne, Brendan; Pereira, Spiro; Hubb, Jonathan; Kirk, Stuart; Gunson, Rory; Bradley-Stewart, Amanda; Aitken, Celia;
• Is Part Of: Journal of infectious diseases. Volume 214:Number 9(2016:Nov. 01)
• Page Start: 1302
• Page End: 1308
• Publication Date: 2016-05-24
• Subjects: tenofovir -- HIV-1 -- subtype -- virological failure -- K65R; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiw213
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Concern has been expressed that tenofovir-containing regimens may have reduced effectiveness in the treatment of human immunodeficiency virus type 1 (HIV-1) subtype C infections because of a propensity for these viruses to develop a key tenofovir-associated resistance mutation. We evaluated whether subtype influenced rates of virological failure in a cohort of 8746 patients from the United Kingdom who received a standard tenofovir-containing first-line regimen and were followed for a median of 3.3 years. In unadjusted analyses, the rate of failure was approximately 2-fold higher among patients infected with subtype C virus as compared to those with subtype B virus (hazard ratio [HR], 1.86; 95% confidence interval [CI], 1.50–2.31; P < .001). However, the increased risk was greatly attenuated in analyses adjusting for demographic and clinical factors (adjusted HR, 1.14; 95% CI, .83–1.58; P = .41). There were no differences between subtypes C and subtypes non-B and non-C in either univariate or multivariate analysis. These observations imply there is no intrinsic effect of viral subtype on the efficacy of tenofovir-containing regimens.