Prevalence of etravirine mutations and impact on response to treatment in routine clinical care: the Swiss HIV Cohort Study (SHCS)

• Published in: HIV medicine 2009-11, Vol.10 (10), p.647-656
• Main Authors: Scherrer, AU, Hasse, B, Von Wyl, V, Yerly, S, Böni, J, Bürgisser, P, Klimkait, T, Bucher, HC, Ledergerber, B, Günthard, HF
• Format: Article
• Language: English
• Subjects: Algorithms; Anti-HIV Agents - therapeutic use; antiretroviral treatment; Cohort Studies; drug resistance; Drug Resistance, Multiple, Viral - genetics; etravirine; Gene Frequency; Genotype; HIV; HIV Infections - drug therapy; HIV Infections - virology; HIV-1 - drug effects; HIV-1 - genetics; Human immunodeficiency virus; Humans; Microbial Sensitivity Tests - methods; Mutation - genetics; nonnucleoside reverse transcriptase inhibitor (NNRTI); Polymorphism, Genetic; Predictive Value of Tests; Pyridazines - therapeutic use; Reverse Transcriptase Inhibitors - therapeutic use; Switzerland; Treatment Failure; Viral Load
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/j.1468-1293.2009.00756.x

Objectives Etravirine (ETV) is a novel nonnucleoside reverse transcriptase inhibitor (NNRTI) with reduced cross‐resistance to first‐generation NNRTIs, which has been primarily studied in randomized clinical trials and not in routine clinical settings. Methods ETV resistance‐associated mutations (RAMs) were investigated by analysing 6072 genotypic tests. The antiviral activity of ETV was predicted using different interpretation systems: International AIDS Society‐USA (IAS‐USA), Stanford, Rega and Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS). Results The prevalence of ETV RAMs was higher in NNRTI‐exposed patients [44.9%, 95% confidence interval (CI) 41.0–48.9%] than in treatment‐naïve patients (9.6%, 95% CI 8.5–10.7%). ETV RAMs in treatment‐naïve patients mainly represent polymorphism, as prevalence estimates in genotypic tests for treatment‐naïve patients with documented recent (