High rates of transmitted NNRTI resistance among persons with acute HIV infection in Malawi: implications for first-line dolutegravir scale-up.

Abstract:

:High rates of non-nucleoside reverse transcriptase inhibitors (NNRTI) resistance was a key consideration in the WHO policies transitioning first-line regimens to include integrase inhibitors (dolutegravir [DTG]). However, recent data suggests a relationship between DTG and neural tube defects among women exposed during conception, giving providers and policymakers pause regarding the planned regimen changes. We examined HIV drug resistance among a cohort of 46 acutely infected persons in Malawi. Our data demonstrates high levels of transmitted resistance, 11% using standard resistance surveillance mutations and 20% when additional NNRTI polymorphisms that may affect treatment response are included. High resistance rates in this treatment-naïve patient population reinforces the critical nature of DTG-based options in the context of public-health driven treatment programs.

journal_name

AIDS Res Ther

authors

Rutstein SE,Chen JS,Nelson JAE,Phiri S,Miller WC,Hosseinipour MC

doi

10.1186/s12981-019-0220-8

subject

Has Abstract

pub_date

2019-02-22 00:00:00

pages

5

issue

1

issn

1742-6405

pii

10.1186/s12981-019-0220-8

journal_volume

16

pub_type

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