Please use this identifier to cite or link to this item: http://cmuir.cmu.ac.th/jspui/handle/6653943832/62814
Title: HIV Drug Resistance in Adults Receiving Early vs. Delayed Antiretroviral Therapy: HPTN 052
Authors: Philip J. Palumbo
Jessica M. Fogel
Sarah E. Hudelson
Ethan A. Wilson
Stephen Hart
Laura Hovind
Estelle Piwowar-Manning
Carole Wallis
Maria A. Papathanasopoulos
Mariza G. Morgado
Shanmugam Saravanan
Srikanth Tripathy
Joseph J. Eron
Joel E. Gallant
Marybeth McCauley
Theresa Gamble
Mina C. Hosseinipour
Nagalingeswaran Kumarasamy
James G. Hakim
Jose H. Pilotto
Johnstone Kumwenda
Victor Akelo
Sheela V. Godbole
Breno R. Santos
Beatriz Grinsztejn
Ravindre Panchia
Suwat Chariyalertsak
Joseph Makhema
Sharlaa Badal-Faesen
Ying Q. Chen
Myron S. Cohen
Susan H. Eshleman
Keywords: Medicine
Issue Date: 15-Apr-2018
Abstract: © 2017 Wolters Kluwer Health, Inc. All rights reserved. Introduction: We evaluated HIV drug resistance in adults who received early vs. delayed antiretroviral therapy (ART) in a multinational trial [HIV Prevention Trials Network (HPTN) 052, enrollment 2005-2010]. In HPTN 052, 1763 index participants were randomized to start ART at a CD4 cell count of 350-550 cells/mm 3 (early ART arm) or <250 cells/mm 3 (delayed ART arm). In May 2011, interim study results showed benefit of early ART, and all participants were offered ART regardless of CD4 cell count; the study ended in 2015. Methods: Virologic failure was defined as 2 consecutive viral loads >1000 copies/mL >24 weeks after ART initiation. Drug resistance testing was performed for pretreatment (baseline) and failure samples from participants with virologic failure. Results: HIV genotyping results were obtained for 211/249 participants (128 early ART arm and 83 delayed ART arm) with virologic failure. Drug resistance was detected in 4.7% of participants at baseline; 35.5% had new resistance at failure. In univariate analysis, the frequency of new resistance at failure was lower among participants in the early ART arm (compared with delayed ART arm, P = 0.06; compared with delayed ART arm with ART initiation before May 2011, P = 0.032). In multivariate analysis, higher baseline viral load (P = 0.0008) and ART regimen (efavirenz/lamivudine/zidovudine compared with other regimens, P = 0.024) were independently associated with higher risk of new resistance at failure. Conclusions: In HPTN 052, the frequency of new drug resistance at virologic failure was lower in adults with early ART initiation. The main factor associated with reduced drug resistance with early ART was lower baseline viral load.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85049073758&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/62814
ISSN: 10779450
15254135
Appears in Collections:CMUL: Journal Articles

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