Free accessCase reportFirst published online 2013-8
Implications of HIV Drug Resistance on First- and Second-Line Therapies in Resource-Limited Settings: Report from a Workshop Organized by the Collaborative HIV and Anti-HIV Drug Resistance Network
Here, we summarize the discussions and conclusions from an expert workshop held in October 2012 to consider the implications of HIV drug resistance in the context of scale-up of access to antiretroviral therapy and prophylaxis in resource-limited settings. Topics considered during the workshop included the implications of drug resistance for the selection of first-line regimens and sequencing of treatments, optimal surveillance strategies and prevention of mother-to-child transmission.
References
1.
World Health Organization.Antiretroviral therapy for HIV infection in adults and adolescents. Recommendations for a public health approach (2010 revision). (15 July 2010. Accessed 14 October 2013.) Available from http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf.
TangM.W., KankiP.J., ShaferR.W.A review of the virological efficacy of the 4 World Health Organization-recommended tenofovir-containing regimens for initial HIV therapy. Clin Infect Dis2012; 54: 862–875.
8.
BackD.J., BurgerD.M., FlexnerC.W., GerberJ.G.The pharmacology of antiretroviral nucleoside and nucleotide reverse transcriptase inhibitors: implications for once-daily dosing. J Acquir Immune Defic Syndr2005; 39Suppl 1: S1–S23.
9.
McCollD.J., MargotN., ChenS.S.Reduced emergence of the M184V/I resistance mutation when antiretroviral-naive subjects use emtricitabine versus lamivudine in regimens composed of two NRTIs plus the NNRTI efavirenz. HIV Clin Trials2011; 12: 61–70.
AdamsJ.L., GreenerB.N., KashubaA.D.Pharmacology of HIV integrase inhibitors. Curr Opin HIV AIDS2012; 7: 390–400.
12.
MessiaenP., WensingA.M., FunA.Clinical use of HIV integrase inhibitors: a systematic review and meta-analysis. PLoS ONE2013; 8: e52562.
13.
LarderB.A., KempS.D., HarriganP.R.Potential mechanism for sustained antiretroviral efficacy of AZT-3TC combination therapy. Science1995; 269: 696–699.
14.
GötteM., ArionD., ParniakM.A., WainbergM.A.The M184V mutation in the reverse transcriptase of human immunodeficiency virus type 1 impairs rescue of chain-terminated DNA synthesis. J Virol2000; 74: 3579–3585.
15.
SunpathH., WuB., GordonM.High rate of K65R for antiretroviral therapy-naive patients with subtype C HIV infection failing a tenofovir-containing first-line regimen. AIDS2012; 26: 1679–1684.
16.
GilksC.F., WalkerA.S., DunnD.T.Lopinavir/ritonavir monotherapy after 24 weeks of second-line antiretroviral therapy in Africa: a randomized controlled trial (SARA). Antivir Ther2012; 17: 1363–1373.
17.
BunupuradahT., ChetchotisakdP., AnanworanichJ.A randomized comparison of second-line lopinavir/ritonavir monotherapy versus tenofovir/lamivudine/lopinavir/ ritonavir in patients failing NNRTI regimens: the HIV STAR study. Antivir Ther2012; 17: 1351–1361.
18.
CrawfordK.W., RipinD.H., LevinA.D., CampbellJ.R., FlexnerC.Optimising the manufacture, formulation, and dose of antiretroviral drugs for more cost-efficient delivery in resource-limited settings: a consensus statement. Lancet Infect Dis2012; 12: 550–560.
19.
World Health Organization.Programmatic update: use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. (Updated April 2012. Accessed 13 November 2012.) Available from http://www.who.int/hiv/pub/mtct/programmatic_update2012/en/index.html.
20.
FogelJ.M., MwathaA., RichardsonP.Impact of maternal and infant antiretroviral drug regimens on drug resistance in HIV-infected breastfeeding infants. Pediatr Infect Dis J2013; 32: e164–e169.
21.
FlynnP.M., MirochnickM., ShapiroD.E.Pharmacokinetics and safety of single-dose tenofovir disoproxil fumarate and emtricitabine in HIV-1-infected pregnant women and their infants. Antimicrob Agents Chemother2011; 55: 5914–5922.
Paediatric European Network for Treatment of AIDS (PENTA).Comparison of dual nucleoside-analogue reverse-transcriptase inhibitor regimens with and without nelfinavir in children with HIV-1 who have not previously been treated: the PENTA 5 randomised trial. Lancet2002; 359: 733–740.
24.
GibbD.M., WalkerA.S., KayeS.Evolution of antiretroviral phenotypic and genotypic drug resistance in antiretroviral-naive HIV-1-infected children treated with abacavir/lamivudine, zidovudine/lamivudine or abacavir/ zidovudine, with or without nelfinavir (the PENTA 5 trial). Antivir Ther2002; 7: 293–303.
25.
OkwunduC.I., UthmanO.A., OkoromahC.A.Antiretroviral pre-exposure prophylaxis (PrEP) for preventing HIV in high-risk individuals. Cochrane Database Syst Rev2012; 7: CD007189.
26.
van de VijverD.A., BoucherC.A.The risk of HIV drug resistance following implementation of pre-exposure prophylaxis. Curr Opin Infect Dis2010; 23: 621–627.
27.
Abdool KarimQ., Abdool KarimS.S., FrohlichJ.A.Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science2010; 329: 1168–1174.
28.
GrantR.M., LamaJ.R., AndersonP.L.Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med2010; 363: 2587–2599.
29.
ReynoldsS., SendagireH., NewellK.Routine VLM reduces the rate of accumulated genotypic resistance to commonly used ART in Uganda.18th Conference on Retroviruses and Opportunistic Infections. 27 February–2 March 2011, Boston MA, USA. Abstract 53.
30.
TaiwoB., GallienS., AgaE.Antiretroviral drug resistance in HIV-1-infected patients experiencing persistent low-level viremia during first-line therapy. J Infect Dis2011; 204: 515–520.
31.
BennettD.E., MyattM., BertagnolioS., SutherlandD., GilksC.F.Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment. Antivir Ther2008; 13Suppl 2: 25–36.
32.
WittkopL., GunthardH.F., de WolfF.Effect of transmitted drug resistance on virological and immunological response to initial combination antiretroviral therapy for HIV (EuroCoord-CHAIN joint project): a European multicohort study. Lancet Infect Dis2011; 11: 363–371.
33.
HamersR.L., WallisC.L., KityoC.HIV-1 drug resistance in antiretroviral-naive individuals in sub-Saharan Africa after rollout of antiretroviral therapy: a multicentre observational study. Lancet Infect Dis2011; 11: 750–759.
