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BRIEF REPORT: HIV DRUG RESISTANCE IN ADULTS FAILING EARLY ANTIRETROVIRAL TREATMENT: RESULTS FROM THE HIV PREVENTION TRIALS NETWORK 052 TRIAL
Author
Fogel, Jessica M.
Hudelson, Sarah E.
Ou, San-San
Hart, Stephen
Wallis, Carole
Morgado, Mariza G.
Saravanan, Shanmugam
Tripathy, Srikanth
Hovind, Laura
Piwowar-Manning, Estelle
Sabin, Devin
McCauley, Marybeth
Gamble, Theresa
Zhang, Xinyi C.
Eron, Joseph J.
Gallant, Joel E.
Kumwenda, Johnstone
Makhema, Joseph
Kumarasamy, Nagalingeswaran
Chariyalertsak, Suwat
Hakim, James
Badal-Faesen, Sharlaa
Akelo, Victor
Hosseinipour, Mina C.
Santos, Breno R.
Godbole, Sheela V.
Pilotto, Jose H.
Grinsztejn, Beatriz
Panchia, Ravindre
Mayer, Kenneth H.
Chen, Ying Q.
Cohen, Myron S.
Eshleman, Susan H.
Hudelson, Sarah E.
Ou, San-San
Hart, Stephen
Wallis, Carole
Morgado, Mariza G.
Saravanan, Shanmugam
Tripathy, Srikanth
Hovind, Laura
Piwowar-Manning, Estelle
Sabin, Devin
McCauley, Marybeth
Gamble, Theresa
Zhang, Xinyi C.
Eron, Joseph J.
Gallant, Joel E.
Kumwenda, Johnstone
Makhema, Joseph
Kumarasamy, Nagalingeswaran
Chariyalertsak, Suwat
Hakim, James
Badal-Faesen, Sharlaa
Akelo, Victor
Hosseinipour, Mina C.
Santos, Breno R.
Godbole, Sheela V.
Pilotto, Jose H.
Grinsztejn, Beatriz
Panchia, Ravindre
Mayer, Kenneth H.
Chen, Ying Q.
Cohen, Myron S.
Eshleman, Susan H.
Affilliation
Johns Hopkins Univ. School of Medicine. Dept. of Pathology. Baltimore, Maryland, USA.
Johns Hopkins Univ. School of Medicine. Dept. of Pathology. Baltimore, Maryland, USA.
Fred Hutchinson Cancer Research Center. Vaccine and Infectious Disease Division. Seattle, VA, USA.
Frontier Science & Technology Research Foundation. Amherst, NY, USA.
Lancet Laboratories and BARC-SA. Specialty Molecular Division. Johannesburg, South Africa.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ. Brasil.
Y. R. Gaitonade Centre for AIDS Research and Education. Chennai, India.
National JALMA Institute for Leprosy and Other Mycobacterial Diseases. Agra, India.
Frontier Science & Technology Research Foundation. Amherst, NY, USA.
Johns Hopkins Univ. School of Medicine. Dept. of Pathology. Baltimore, MD, USA.
Johns Hopkins Univ. School of Medicine. Dept. of Pathology. Baltimore, MD, USA.
Science Facilitation Department. FHI 360. Washington, DC, USA.
Science Facilitation Department. FHI 360, Durham, NC, USA.
Fred Hutchinson Cancer Research Center. Vaccine and Infectious Disease Division. Seattle, WA, USA.
Univ. of North Carolina at Chapel Hill. Dept. of Medicine. Chapel Hill, NC, USA.
Southwest CARE Center. Santa Fe, NM, USA.
College of Medicine. Johns Hopkins Project. Blantyre, Malawi.
Botswana Harvard AIDS Institute. Gaborone, Botswana.
YRGCARE Medical Centre.VHS. Chennai, India.
Chiang Mai University. Research Institute for Health Sciences. Chiang Mai, Thailand.
University of Zimbabwe. Dept. of Medicine. Harare, Zimbabwe.
Univ. of Witwatersrand. Johannesburg, South Africa.
Kenya Medical Research Institute. Kisumu, Kenya. / Center for Disease Control. Kisumu, Kenya.
Univ. of North Carolina at Chapel Hill. Division of Infectious Diseases. Chapel Hill, NC, USA / UNC Project-Malawi. Institute for Global Health and Infectious Diseases. Lilongwe, Malawi.
Hospital Nossa Senhora da Conceição. Serviço de Infectologia. Porto Alegre, RS, Brasil.
National AIDS Research Institute (ICMR). Pune, India.
Hospital Geral de Nova Iguacu. Nova Iguaçu, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
University of the Witwatersrand. Perinatal HIV Research Unit. Soweto, South Africa.
The Fenway Institute. Fenway Health and Infectious Disease Division. Boston, MA, USA / Harvard Medical School. Beth Israel Deaconess Medical Center/Dept. of Medicine. Boston, MA, USA.
Fred Hutchinson Cancer Research Center. Vaccine and Infectious Disease Division and Public Health Sciences Division. Seattle, VA, USA.
Univ. of North Carolina at Chapel Hill. Department of Medicine. Chapel Hill, NC, USA.
Univ. of North Carolina at Chapel Hill. Dept. of Pathology. Baltimore, MD, USA.
Johns Hopkins Univ. School of Medicine. Dept. of Pathology. Baltimore, Maryland, USA.
Fred Hutchinson Cancer Research Center. Vaccine and Infectious Disease Division. Seattle, VA, USA.
Frontier Science & Technology Research Foundation. Amherst, NY, USA.
Lancet Laboratories and BARC-SA. Specialty Molecular Division. Johannesburg, South Africa.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ. Brasil.
Y. R. Gaitonade Centre for AIDS Research and Education. Chennai, India.
National JALMA Institute for Leprosy and Other Mycobacterial Diseases. Agra, India.
Frontier Science & Technology Research Foundation. Amherst, NY, USA.
Johns Hopkins Univ. School of Medicine. Dept. of Pathology. Baltimore, MD, USA.
Johns Hopkins Univ. School of Medicine. Dept. of Pathology. Baltimore, MD, USA.
Science Facilitation Department. FHI 360. Washington, DC, USA.
Science Facilitation Department. FHI 360, Durham, NC, USA.
Fred Hutchinson Cancer Research Center. Vaccine and Infectious Disease Division. Seattle, WA, USA.
Univ. of North Carolina at Chapel Hill. Dept. of Medicine. Chapel Hill, NC, USA.
Southwest CARE Center. Santa Fe, NM, USA.
College of Medicine. Johns Hopkins Project. Blantyre, Malawi.
Botswana Harvard AIDS Institute. Gaborone, Botswana.
YRGCARE Medical Centre.VHS. Chennai, India.
Chiang Mai University. Research Institute for Health Sciences. Chiang Mai, Thailand.
University of Zimbabwe. Dept. of Medicine. Harare, Zimbabwe.
Univ. of Witwatersrand. Johannesburg, South Africa.
Kenya Medical Research Institute. Kisumu, Kenya. / Center for Disease Control. Kisumu, Kenya.
Univ. of North Carolina at Chapel Hill. Division of Infectious Diseases. Chapel Hill, NC, USA / UNC Project-Malawi. Institute for Global Health and Infectious Diseases. Lilongwe, Malawi.
Hospital Nossa Senhora da Conceição. Serviço de Infectologia. Porto Alegre, RS, Brasil.
National AIDS Research Institute (ICMR). Pune, India.
Hospital Geral de Nova Iguacu. Nova Iguaçu, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
University of the Witwatersrand. Perinatal HIV Research Unit. Soweto, South Africa.
The Fenway Institute. Fenway Health and Infectious Disease Division. Boston, MA, USA / Harvard Medical School. Beth Israel Deaconess Medical Center/Dept. of Medicine. Boston, MA, USA.
Fred Hutchinson Cancer Research Center. Vaccine and Infectious Disease Division and Public Health Sciences Division. Seattle, VA, USA.
Univ. of North Carolina at Chapel Hill. Department of Medicine. Chapel Hill, NC, USA.
Univ. of North Carolina at Chapel Hill. Dept. of Pathology. Baltimore, MD, USA.
Abstract
Early initiation of antiretroviral treatment (ART) reduces HIV transmission and has health benefits. HIV drug resistance can limit treatment options and compromise use of ART for HIV prevention. We evaluated drug resistance in 85 participants in the HIV Prevention Trials Network 052 trial who started ART at CD4 counts of 350-550 cells per cubic millimeter and failed ART by May 2011; 8.2% had baseline resistance and 35.3% had resistance at ART failure. High baseline viral load and less education were associated with emergence of resistance at ART failure. Resistance at ART failure was observed in 7 of 8 (87.5%) participants who started ART at lower CD4 cell counts.
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