title: Prevalence of Antiretroviral Drug Resistance in Patients Who Are Not Responding to Protease Inhibitor-Based Treatment: Results From the First National Survey in South Africa.
abstract: Limited data exist on human immunodeficiency virus type 1 (HIV-1) resistance in patients who are not responding to protease inhibitor (PI)-based regimens in resource-limited settings. This study assessed resistance profiles in adults across South Africa who were not responding to PI-based regimens. pol sequencing was undertaken and submitted to the Stanford HIV Drug Resistance Database. At least 1 major PI mutation was detected in 16.4% of 350 participants. A total of 53.4% showed intermediate resistance to darunavir/ritonavir, whereas high-level resistance was not observed. Only 5.2% and 32.8% of participants showed high-level and intermediate resistance to etravirine, respectively. Although the prevalence of major PI mutations was within previously reported ranges, most patients will likely experience virological suppression during receipt of currently available South African third-line regimens.
authors.affiliation: Department of Molecular Medicine and Haematology.
authors.forename: K
authors.initials: K
authors.lastname: Steegen
authors.affiliation: National Health Laboratory Services.
authors.forename: M
authors.initials: M
authors.lastname: Bronze
authors.affiliation: Department of Molecular Medicine and Haematology.
authors.forename: M A
authors.initials: MA
authors.lastname: Papathanasopoulos
authors.affiliation: National Health Laboratory Services.|Division of Medical Virology, Stellenbosch University, Stellenbosch.
authors.forename: G
authors.initials: G
authors.lastname: van Zyl
authors.affiliation: National Health Laboratory Services.|Department of Medical Microbiology and Virology.
authors.forename: D
authors.initials: D
authors.lastname: Goedhals
authors.affiliation: Department of Internal Medicine, University of the Free State, Bloemfontein, South Africa.
authors.forename: C
authors.initials: C
authors.lastname: Van Vuuren
authors.affiliation: Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand.|Center for Global Health and Development, Boston University School of Public Health, Massachusetts.
authors.forename: W
authors.initials: W
authors.lastname: Macleod
authors.affiliation: Center for Global Health and Development, Boston University School of Public Health, Massachusetts.
authors.forename: I
authors.initials: I
authors.lastname: Sanne
authors.affiliation: Department of Molecular Medicine and Haematology.|National Health Laboratory Services.
authors.forename: W S
authors.initials: WS
authors.lastname: Stevens
authors.affiliation: Department of Molecular Medicine and Haematology.|National Health Laboratory Services.
authors.forename: S C
authors.initials: SC
authors.lastname: Carmona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral; D015684:Gene Products, pol / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D017320:HIV Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D020125:Mutation, Missense; D015995:Prevalence; D017422:Sequence Analysis, DNA; D013019:South Africa / Q000453:epidemiology; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D015684:Gene Products, pol; D017320:HIV Protease Inhibitors
keywords: HIV-1 antiretroviral drug resistance; PI-based treatment failure; South Africa