Trends in decline of antiretroviral resistance among ARV-experienced patients in the HIV outpatient study: 1999-2008

Kate Buchacz*, Rose Baker, Douglas J. Ward, Frank J. Palella, Joan S. Chmiel, Benjamin Young, Bienvenido G. Yangco, Richard M. Novak, John T. Brooks

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background. Little is known about temporal trends in frequencies of clinically relevant ARV resistance mutations in HIV strains from U.S. patients undergoing genotypic testing (GT) in routine HIV care. Methods. We analyzed cumulative frequency of HIV resistance among patients in the HIV Outpatient Study (HOPS) who, during 1999-2008 and while prescribed antiretrovirals, underwent GT with plasma HIV RNA >1,000 copies/mL. Exposure ≥4 months to each of three major antiretroviral classes (NRTI, NNRTI and PI) was defined as triple-class exposure (TCE). Results. 906 patients contributed 1,570 GT results. The annual frequency of any major resistance mutations decreased during 1999-2008 (88% to 79%, P = 0.05). Resistance to PIs decreased among PI-exposed patients (71% to 46%, P = 0.010) as exposure to ritonavir-boosted PIs increased (6% to 81%, P < 0.001). Non-significant declines were observed in resistance to NRTIs among NRTI-exposed (82% to 67%), and triple-class-resistance among TCE patients (66% to 41%), but not to NNRTIs among NNRTI-exposed. Conclusions. HIV resistance was common but declined in HIV isolates from subgroups of ARV-experienced HOPS patients during 1999-2008. Resistance to PIs among PI-exposed patients decreased, possibly due to increased representation of patients whose only PI exposures were to boosted PIs.

Original languageEnglish (US)
Article number230290
JournalAIDS Research and Treatment
Volume2012
DOIs
StatePublished - Dec 1 2012

ASJC Scopus subject areas

  • Immunology and Allergy
  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Trends in decline of antiretroviral resistance among ARV-experienced patients in the HIV outpatient study: 1999-2008'. Together they form a unique fingerprint.

  • Cite this