Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 May 15;46(10):1589-97.
doi: 10.1086/587109.

Prevalence of HIV-1 drug resistance after failure of a first highly active antiretroviral therapy regimen in KwaZulu Natal, South Africa

Vincent C Marconi  1 , Henry Sunpath, Zhigang Lu, Michelle Gordon, Kofi Koranteng-Apeagyei, Jane Hampton, Steve Carpenter, Janet Giddy, Douglas Ross, Helga Holst, Elena Losina, Bruce D Walker, Daniel R Kuritzkes; South Africa Resistance Cohort Study Team
Collaborators, Affiliations

Prevalence of HIV-1 drug resistance after failure of a first highly active antiretroviral therapy regimen in KwaZulu Natal, South Africa

Vincent C Marconi et al. Clin Infect Dis. .

Abstract

Background: Emergence of human immunodeficiency virus type 1 (HIV-1) drug resistance may limit the benefits of antiretroviral therapy in resource-limited settings. The prevalence of resistance was assessed among patients from KwaZulu Natal, South Africa, following failure of their first highly active antiretroviral therapy (HAART) regimen.

Methods: Genotypic resistance testing was performed on plasma virus samples from patients who experienced virologic failure of their first HAART regimen at 2 clinics in KwaZulu Natal. Clinical and demographic data were obtained from medical records. Regression analysis was performed to determine factors associated with > or =1 significant drug resistance mutation.

Results: From January 2005 through August 2006, a total of 124 antiretroviral-treated adults who experienced virologic failure were enrolled. The predominant subtype was HIV-1C. Virus samples from 83.5% of participants carried > or =1 significant drug resistance mutation. Dual-class drug-resistant virus was present in 64.3% of participants, and 2.6% had virus with triple-class drug resistance. The most common mutation was M184V/I (64.3% of patients); K103N was present in virus from 51.3%, and V106M was present in virus from 19.1%. Thymidine analog resistance mutations were found in virus from 32.2% of patients, and protease resistance mutations were found in virus from 4.4%.

Conclusions: Antiretroviral drug-resistant virus was detected in >80% of South African patients who experienced failure of a first HAART regimen. Patterns of drug resistance reflected drugs used in first-line regimens and viral subtype. Continued surveillance of resistance patterns is warranted to guide selection of second-line regimens.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: Dr. Kuritzkes served as a consultant to and received research support from Bayer HealthCare Diagnostics (now Siemens). The other authors report no potential conflicts of interest.

Comment in

References

    1. UNAIDS 2006 Report on the Global AIDS Epidemic, 2006

    1. Kuritzkes DR. Extending antiretroviral therapy to resource-poor settings: implications for drug resistance. Aids. 2004;18 (Suppl 3):S45–8. - PubMed
    1. Lange JM, Perriens J, Kuritzkes D, Zewdie D. What policymakers should know about drug resistance and adherence in the context of scaling-up treatment of HIV infection. Aids. 2004;18 (Suppl 3):S69–74. - PubMed
    1. Severe P, Leger P, Charles M, et al. Antiretroviral therapy in a thousand patients with AIDS in Haiti. N Engl J Med. 2005;353:2325–34. - PubMed
    1. Egger M. Outcomes of ART in Resource-limited and Industrialized Countries. Program and Abstracts of the 14th Conference on Retroviruses and Opportunistic Infections; 2007; Los Angeles. Abstract #62.

Publication types

MeSH terms