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. 2020 Jun:95:125-132.
doi: 10.1016/j.ijid.2020.02.020. Epub 2020 Feb 17.

High rates of tenofovir failure in a CRF01_AE-predominant HIV epidemic in the Philippines

Edsel Maurice T Salvana  1 , Genesis May J Samonte  2 , Elizabeth Telan  3 , Katerina Leyritana  4 , Rosario Jessica Tactacan-Abrenica  5 , Patrick R Ching  6 , Geraldine M Arevalo  7 , Niña Theresa Dungca  7 , Christine Peñalosa-Ramos  6 , Kevin Anthony R Mendoza  2 , Lyka F Trinidad  2 , Angelo Dela Tonga  7 , Jodor Lim  6 , Raul Destura  1 , Marissa Alejandria  6 , Rontgene Solante  5 , Lalaine Arcangel  5 , Noel S Palaypayon  2 , Brian E Schwem  8
Affiliations
Free article

High rates of tenofovir failure in a CRF01_AE-predominant HIV epidemic in the Philippines

Edsel Maurice T Salvana et al. Int J Infect Dis. 2020 Jun.
Free article

Abstract

Background: The Philippines has the fastest growing HIV epidemic in the Asia-Pacific. This increase was accompanied by a shift in the predominant HIV subtype from B to CRF01_AE. Increasing evidence points to a difference in treatment responses between subtypes. We examined treatment failure and acquired drug resistance (ADR) in people living with HIV (PLHIVs) after one year on antiretrovirals (ARVs).

Methods: PLHIV maintained on ARVs for one year were recruited. Treatment failure was defined as a viral load of ≥1000 copies/mL. Sanger sequencing for genotyping and drug resistance mutation (DRM) detection was performed on patients failing treatment.

Results: 513 PLHIV were enrolled. The most common antiretroviral regimens were TDF+3TC + EFV (269) and AZT+3TC + EFV (155). 53 (10.3%) subjects failed treatment. Among these, 48 (90.6%) had DRMs, 84.9% were subtype CRF01_AE. Tenofovir-based regimens performed worse than zidovudine-based regimens (OR 3.28, 95% CI 1.58-7.52 p < 0.001). Higher rates of NRTI, NNRTI, K65R tenofovir resistance, and multi-class resistance were found compared to those reported in literature.

Conclusions: HIV treatment failure at one year of treatment in the Philippines is 10.3%. We found unusually high tenofovir and multiclass resistance, and optimal ARV regimens may need to be reevaluated for CRF01_AE-predominant epidemics.

Keywords: Drug resistance; HIV; K65R; Philippines.

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