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Pre-treatment minority HIV-1 drug resistance mutations and long term virological outcomes: is prediction possible?

Overview of attention for article published in Virology Journal, October 2016
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Title
Pre-treatment minority HIV-1 drug resistance mutations and long term virological outcomes: is prediction possible?
Published in
Virology Journal, October 2016
DOI 10.1186/s12985-016-0628-x
Pubmed ID
Authors

M. L. Mzingwane, C. T. Tiemessen, K. L. Richter, S. H. Mayaphi, G. Hunt, S. M. Bowyer

Abstract

Although the use of highly active antiretroviral therapy in HIV positive individuals has proved to be effective in suppressing the virus to below detection limits of commonly used assays, virological failure associated with drug resistance is still a major challenge in some settings. The prevalence and effect of pre-treatment resistance associated variants on virological outcomes may also be underestimated because of reliance on conventional population sequencing data which excludes minority species. We investigated long term virological outcomes and the prevalence and pattern of pre-treatment minority drug resistance mutations in individuals initiating HAART at a local HIV clinic. Patient's records of viral load results and CD4 cell counts from routine treatment monitoring were used and additional pre-treatment blood samples for Sanger sequencing were obtained. A selection of pre-treatment samples from individuals who experienced virological failure were evaluated for minority resistance associated mutations to 1 % prevalence and compared to individuals who achieved viral suppression. At least one viral load result after 6 months or more of treatment was available for 65 out of 78 individuals followed for up to 33 months. Twenty (30.8 %) of the 65 individuals had detectable viremia and eight (12.3 %) of them had virological failure (viral load > 1000 RNA copies/ml) after at least 6 months of HAART. Viral suppression, achieved by month 8 to month 13, was followed by low level viremia in 10.8 % of patients and virological failure in one patient after month 20. There was potentially reduced activity to Emtricitabine or Tenofovir in three out of the eight cases in which minority drug resistance associated variants were investigated but detectable viremia occurred in one of these cases while the activity of Efavirenz was generally reduced in all the eight cases. Early viral suppression was followed by low level viremia for some patients which may be an indication of failure to sustain viral suppression over time. The low level viremia may also be representing early stages of resistance development. The mutation patterns detected in the minority variants showed potential reduced drug sensitivity which highlights their potential to dominate after treatment initiation. Not applicable.

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Mendeley readers

The data shown below were compiled from readership statistics for 51 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 51 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 15 29%
Researcher 8 16%
Student > Bachelor 7 14%
Student > Postgraduate 5 10%
Other 3 6%
Other 8 16%
Unknown 5 10%
Readers by discipline Count As %
Medicine and Dentistry 19 37%
Biochemistry, Genetics and Molecular Biology 9 18%
Immunology and Microbiology 9 18%
Agricultural and Biological Sciences 4 8%
Nursing and Health Professions 3 6%
Other 2 4%
Unknown 5 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 August 2017.
All research outputs
#8,944,919
of 11,642,880 outputs
Outputs from Virology Journal
#1,437
of 1,989 outputs
Outputs of similar age
#169,334
of 259,149 outputs
Outputs of similar age from Virology Journal
#22
of 34 outputs
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