Evolution of drug resistance after virological failure of a first-line highly active antiretroviral therapy regimen in Uganda.
BACKGROUND
This study aimed to determine the extent of viral resistance over time among non-clade B HIV type-1-infected patients in Uganda who were maintained on first-line highly active antiretroviral therapy (HAART) following virological failure.


METHODS
Genotyping was performed on 16 patients with virological failure who were enrolled in an open-label randomized clinical trial of short-cycle treatment interruption.


RESULTS
All patients receiving efavirenz-containing HAART had > or =1 efavirenz resistance mutation develop during follow-up. The majority (13/15, 86%) developed lamivudine resistance during follow-up, but no thymidine analogue mutations (TAMs) developed during a median duration of virological failure of 325.5 days.


CONCLUSIONS
Genotype resistance to both efavirenz and lamivudine developed early during the course of treatment after virological failure. TAMs did not emerge early despite moderate exposure time to thymidine analogues during virological failure.
Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA. sjr@jhmi.edu
Steven J
SJ
Reynolds
Cissy
C
Kityo
Frank
F
Mbamanya
Robin
R
Dewar
Francis
F
Ssali
Thomas C
TC
Quinn
Peter
P
Mugyenyi
Mark
M
Dybul
D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D048588:Benzoxazines / Q000627:therapeutic use; D003521:Cyclopropanes; D024882:Drug Resistance, Viral / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D009154:Mutation / Q000187:drug effects; D013936:Thymidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017211:Treatment Failure; D014454:Uganda
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D019259:Lamivudine; C098320:efavirenz; D013936:Thymidine