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Home >> Publications >> High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau.

Publication

Author(s):

Jespersen S1,2, Tolstrup M3, Hønge BL4,5,6, Medina C7, Té Dda S8, Ellermann-Eriksen S9, Østergaard L10, Wejse C11,12, Laursen AL13; Bissau HIV cohort study group.

Pub Title:

High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau.

Pub Date:

Mar 11 2015

Pub Region(s):

West Africa

Journal Issue:

12

Page Number:
41

Journal:

Title: 
Virology Journal
Link: 
http://www.virologyj.com/content/12/1/41

PubMed: 25889017
Pub PDF:

BACKGROUND: With the widespread use of antiretroviral treatment (ART) in Africa, the risk of drug resistance has increased. The aim of this study was to evaluate levels of HIV-1 resistance among patients with HIV-1 and HIV-1/2 dual infections, treated with ART, at a large HIV clinic in Guinea-Bissau.

FINDINGS:

Patients were selected from the Bissau HIV cohort. All patients had HIV-1 or HIV-1/2 dual infection, a CD4 cell count performed before and 3-12 months after starting ART, and a corresponding available plasma sample. We measured viral load in patients with HIV-1 (n = 63) and HIV-1/2 dual (n = 16) infections a median of 184 days after starting ART (IQR: 126-235 days). In patients with virological failure (defined as viral load >1000 copies/ml) and with sufficient plasma available, we performed an HIV-1 genotypic resistance test. Thirty-six patients (46%) had virological failure. The CD4 cell count did not predict treatment failure. Of the 36 patients with virological failure, we performed a resistance test in 15 patients (42%), and nine patients (9/15; 60%) had resistance mutations. The most common mutation was K103N, which confers high-level resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI). No major mutations against protease inhibitors (PI) were found.

CONCLUSIONS:

Our results showed that patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau had a high rate of virological failure and rapid development of NNRTI resistance. It remains to be determined whether a more robust, PI-based treatment regimen might benefit this population more than NNRTIs.

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Citation:

Jespersen S, Tolstrup M, Hønge BL, Medina C, Té Dda S, Ellermann-Eriksen S, Østergaard L, Wejse C, Laursen AL; Bissau HIV cohort study group. High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau. Virol J. 2015 Mar 11;12:41. doi: 10.1186/s12985-015-0273-9. PubMed PMID: 25889017; PubMed Central PMCID: PMC4357169.