Prevalence of Antiretroviral Drug Resistance in Patients Who Are Not Responding to Protease Inhibitor–Based Treatment: Results From the First National Survey in South Africa

• Published in: The Journal of infectious diseases 2016-12, Vol.214 (12), p.1826-1830
• Main Authors: Steegen, K., Bronze, M., Papathanasopoulos, M. A., van Zyl, G., Goedhals, D., Van Vuuren, C., Macleod, W., Sanne, I., Stevens, W. S., Carmona, S. C.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anti-Retroviral Agents - pharmacology; Anti-Retroviral Agents - therapeutic use; Cross-Sectional Studies; Drug Resistance, Viral; Gene Products, pol - genetics; HIV Infections - drug therapy; HIV Infections - virology; HIV Protease Inhibitors - pharmacology; HIV Protease Inhibitors - therapeutic use; HIV-1 - drug effects; HIV-1 - isolation & purification; HIV/AIDS; Humans; Middle Aged; Mutation, Missense; Prevalence; Sequence Analysis, DNA; South Africa - epidemiology; Treatment Failure; Young Adult
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiw491

Limited data exist on human immunodeficiency virus type 1 (HIV-1) resistance in patients who are not responding to protease inhibitor (PI)-based regimens in resource-limited settings. This study assessed resistance profiles in adults across South Africa who were not responding to PI-based regimens. pol sequencing was undertaken and submitted to the Stanford HIV Drug Resistance Database. At least 1 major PI mutation was detected in 16.4% of 350 participants. A total of 53.4% showed intermediate resistance to darunavir/ritonavir, whereas high-level resistance was not observed. Only 5.2% and 32.8% of participants showed high-level and intermediate resistance to etravirine, respectively. Although the prevalence of major PI mutations was within previously reported ranges, most patients will likely experience virological suppression during receipt of currently available South African third-line regimens.