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Improved Prediction of Salvage Antiretroviral Therapy Outcomes Using Ultrasensitive HIV-1 Drug Resistance Testing

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dc.contributor Universitat de Vic - Universitat Central de Catalunya. Càtedra de la Sida i Malalties Relacionades
dc.contributor.author Pou, Christian
dc.contributor.author Noguera-Julian, Marc
dc.contributor.author Pérez-Alvarez, Susana
dc.contributor.author Garcia, Federico
dc.contributor.author Delgado, Rafael
dc.contributor.author Dalmau, David
dc.contributor.author Álvarez-Tejado, Miguel
dc.contributor.author González, Dimitri
dc.contributor.author Chueca, Natalia
dc.contributor.author Sayada, Chalom
dc.contributor.author Pulido, Federico
dc.contributor.author Ibáñez, Laura
dc.contributor.author Rodríguez, Cristina
dc.contributor.author Casadellà, Maria
dc.contributor.author Santos, José R.
dc.contributor.author Ruiz, Lídia
dc.contributor.author Clotet, Bonaventura
dc.contributor.author Paredes, Roger
dc.date.accessioned 2014-09-16T18:06:39Z
dc.date.available 2014-09-16T18:06:39Z
dc.date.created 2014
dc.date.issued 2014
dc.identifier.citation Pou, C., Noguera-Julian, M., Pérez-Álvarez, S., García, F., Delgado, R., Dalmau, D., et al. (2014). Improved prediction of salvage antiretroviral therapy outcomes using ultrasensitive HIV-1 drug resistance testing. Clinical Infectious Diseases, 59(4), 578-588.10.1093/cid/ciu287 ca_ES
dc.identifier.issn 1537-6591
dc.identifier.uri http://hdl.handle.net/10854/3261
dc.description.abstract Background. The clinical relevance of ultrasensitive human immunodeficiency virus type 1 (HIV-1) genotypic resistance testing in antiretroviral treatment (ART)-experienced individuals remains unknown. Methods. This was a retrospective, multicentre, cohort study in ART-experienced, HIV-1-infected adults who initiated salvage ART including, at least 1 ritonavir-boosted protease inhibitor, raltegravir or etravirine. Presalvage ART Sanger and 454 sequencing of plasma HIV-1 were used to generate separate genotypic sensitivity scores (GSS) using the HIVdb, ANRS, and REGA algorithms. Virological failure (VF) was defined as 2 consecutive HIV-1 RNA levels ≥200 copies/mL at least 12 weeks after salvage ART initiation, whereas subjects remained on the same ART. The ability of Sanger and 454-GSS to predict VF was assessed by receiver operating characteristic (ROC) curves and survival analyses. Results. The study included 132 evaluable subjects; 28 (21%) developed VF. Using HIVdb, 454 predicted VF better than Sanger sequencing in the ROC curve analysis (area under the curve: 0.69 vs 0.60, Delong test P = .029). Time toVF was shorter for subjects with 454-GSS < 3 vs 454-GSS ≥ 3 (Log-rank P = .003) but not significantly different between Sanger-GSS < 3 and ≥3. Factors independently associated with increased risk of VF in multivariate Cox regression were a 454-GSS < 3 (HR = 4.6, 95 CI, [1.5, 14.0], P = .007), and the number of previous antiretrovirals received (HR = 1.2 per additional drug, 95 CI, [1.1, 1.3], P = .001). Equivalent findings were obtained with the ANRS and REGA algorithms. Conclusions. Ultrasensitive HIV-1 genotyping improves GSS-based predictions of virological outcomes of salvage ART relative to Sanger sequencing. Thismay improve the clinical management of ART-experienced subjects living with HIV-1. Clinical Trials Registration. NCT01346878. Keywords. HIV-1; antiretroviral drug resistance; deep sequencing; salvage antiretroviral therapy; genotypic susceptibility score. en
dc.format application/pdf
dc.format.extent 11 p. ca_ES
dc.language.iso eng ca_ES
dc.publisher Oxford University Press ca_ES
dc.rights (c) Oxford University Press
dc.rights Tots els drets reservats ca_ES
dc.subject.other Sida -- Tractament ca_ES
dc.title Improved Prediction of Salvage Antiretroviral Therapy Outcomes Using Ultrasensitive HIV-1 Drug Resistance Testing en
dc.type info:eu-repo/semantics/article ca_ES
dc.identifier.doi https://doi.org/10.1093/cid/ciu287
dc.relation.publisherversion http://cid.oxfordjournals.org/content/59/4/578.long
dc.rights.accesRights info:eu-repo/semantics/closedAccess ca_ES
dc.type.version info:eu-repo/publishedVersion ca_ES
dc.indexacio Indexat a WOS/JCR
dc.indexacio Indexat a SCOPUS ca_ES

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