dc.contributor |
Universitat de Vic - Universitat Central de Catalunya. Càtedra de la Sida i Malalties Relacionades |
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dc.contributor.author |
Pou, Christian |
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dc.contributor.author |
Noguera-Julian, Marc |
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dc.contributor.author |
Pérez-Alvarez, Susana |
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dc.contributor.author |
Garcia, Federico |
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dc.contributor.author |
Delgado, Rafael |
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dc.contributor.author |
Dalmau, David |
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dc.contributor.author |
Álvarez-Tejado, Miguel |
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dc.contributor.author |
González, Dimitri |
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dc.contributor.author |
Chueca, Natalia |
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dc.contributor.author |
Sayada, Chalom |
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dc.contributor.author |
Pulido, Federico |
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dc.contributor.author |
Ibáñez, Laura |
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dc.contributor.author |
Rodriguez Carbonell, Cristina |
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dc.contributor.author |
Casadellà, Maria |
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dc.contributor.author |
Santos, José R. |
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dc.contributor.author |
Ruiz, Lídia |
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dc.contributor.author |
Clotet, Bonaventura |
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dc.contributor.author |
Paredes, Roger |
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dc.date.accessioned |
2014-09-16T18:06:39Z |
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dc.date.available |
2014-09-16T18:06:39Z |
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dc.date.created |
2014 |
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dc.date.issued |
2014 |
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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 |
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dc.identifier.uri |
http://hdl.handle.net/10854/3261 |
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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 |
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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 |
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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 |
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dc.relation.publisherversion |
http://cid.oxfordjournals.org/content/59/4/578.long |
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dc.rights.accessRights |
info:eu-repo/semantics/closedAccess |
ca_ES |
dc.type.version |
info:eu-repo/publishedVersion |
ca_ES |
dc.indexacio |
Indexat a WOS/JCR |
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dc.indexacio |
Indexat a SCOPUS |
ca_ES |