Viremia and HIV-1 drug resistance mutations among patients receiving second-line highly active antiretroviral therapy in Chennai, Southern India

Shanmugam Saravanan, Madhavan Vidya, Pachamuthu Balakrishnan, Rami Kantor, Sunil Solomon, David Katzenstein, Nagalingeswaran Kumarasamy, Tokugha Yeptomi, Sathasivam Sivamalar, Samara Rifkin, Kenneth H. Mayer, Suniti Solomon

Research output: Contribution to journalArticle

Abstract

Background. A cross-sectional study among individuals receiving second-line antiretroviral treatment was conducted to report on the level of detectable viremia and the types of drug resistance mutations among those with detectable human immunodeficiency virus (HIV) type 1 plasma viral loads (PVLs). Methods. PVLs were measured using Abbott m2000rt real-time polymerase chain reaction, and genotyping was performed with the ViroSeq genotyping system, version 2.0, and ViroSeq analysis software, version 2.8.Results.Of 107 patient plasma specimens consecutively analyzed, 30 (28%) had undetectable PVLs (2000 copies/mL: 33 patients (73%) had 1 of the protease (PR) inhibitor mutations; 41 (91%) had nucleoside reverse-transcriptase inhibitor (NRTI) mutations; 33 (73%) had non-NRTI (NNRTI) mutations; and 30 (66.7%) had both NRTI and NNRTI mutations. Triple-class resistance to NRTIs, NNRTIs, and PR inhibitors was observed in 24 (53%) patients. Based on the mutational profiles observed, all 45 sequences were susceptible to darunavir and tipranavir, whereas 47% showed resistance to lopinavir, 58% showed resistance to atazanavir, and >60% showed resistance to saquinavir, indinavir, nelfinavir, and fosamprenavir. Conclusions. The results of the study showed that the majority of patients receiving second-line antiretroviral therapy started to accumulate PR resistance mutations, and the mutation profiles suggest that darunavir might be the drug of choice for third-line regimens in India.

Original languageEnglish (US)
Pages (from-to)995-1000
Number of pages6
JournalClinical Infectious Diseases
Volume54
Issue number7
DOIs
StatePublished - Apr 1 2012
Externally publishedYes

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Viremia
Highly Active Antiretroviral Therapy
Drug Resistance
HIV-1
India
Mutation
Reverse Transcriptase Inhibitors
Viral Load
Protease Inhibitors
Nucleosides
Nelfinavir
Saquinavir
Lopinavir
Indinavir
Real-Time Polymerase Chain Reaction
Peptide Hydrolases
Software
Cross-Sectional Studies
Therapeutics
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

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Viremia and HIV-1 drug resistance mutations among patients receiving second-line highly active antiretroviral therapy in Chennai, Southern India. / Saravanan, Shanmugam; Vidya, Madhavan; Balakrishnan, Pachamuthu; Kantor, Rami; Solomon, Sunil; Katzenstein, David; Kumarasamy, Nagalingeswaran; Yeptomi, Tokugha; Sivamalar, Sathasivam; Rifkin, Samara; Mayer, Kenneth H.; Solomon, Suniti.

In: Clinical Infectious Diseases, Vol. 54, No. 7, 01.04.2012, p. 995-1000.

Research output: Contribution to journalArticle

Saravanan, S, Vidya, M, Balakrishnan, P, Kantor, R, Solomon, S, Katzenstein, D, Kumarasamy, N, Yeptomi, T, Sivamalar, S, Rifkin, S, Mayer, KH & Solomon, S 2012, 'Viremia and HIV-1 drug resistance mutations among patients receiving second-line highly active antiretroviral therapy in Chennai, Southern India', Clinical Infectious Diseases, vol. 54, no. 7, pp. 995-1000. https://doi.org/10.1093/cid/cir967
Saravanan, Shanmugam ; Vidya, Madhavan ; Balakrishnan, Pachamuthu ; Kantor, Rami ; Solomon, Sunil ; Katzenstein, David ; Kumarasamy, Nagalingeswaran ; Yeptomi, Tokugha ; Sivamalar, Sathasivam ; Rifkin, Samara ; Mayer, Kenneth H. ; Solomon, Suniti. / Viremia and HIV-1 drug resistance mutations among patients receiving second-line highly active antiretroviral therapy in Chennai, Southern India. In: Clinical Infectious Diseases. 2012 ; Vol. 54, No. 7. pp. 995-1000.
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T1 - Viremia and HIV-1 drug resistance mutations among patients receiving second-line highly active antiretroviral therapy in Chennai, Southern India

AU - Saravanan, Shanmugam

AU - Vidya, Madhavan

AU - Balakrishnan, Pachamuthu

AU - Kantor, Rami

AU - Solomon, Sunil

AU - Katzenstein, David

AU - Kumarasamy, Nagalingeswaran

AU - Yeptomi, Tokugha

AU - Sivamalar, Sathasivam

AU - Rifkin, Samara

AU - Mayer, Kenneth H.

AU - Solomon, Suniti

PY - 2012/4/1

Y1 - 2012/4/1

N2 - Background. A cross-sectional study among individuals receiving second-line antiretroviral treatment was conducted to report on the level of detectable viremia and the types of drug resistance mutations among those with detectable human immunodeficiency virus (HIV) type 1 plasma viral loads (PVLs). Methods. PVLs were measured using Abbott m2000rt real-time polymerase chain reaction, and genotyping was performed with the ViroSeq genotyping system, version 2.0, and ViroSeq analysis software, version 2.8.Results.Of 107 patient plasma specimens consecutively analyzed, 30 (28%) had undetectable PVLs (2000 copies/mL: 33 patients (73%) had 1 of the protease (PR) inhibitor mutations; 41 (91%) had nucleoside reverse-transcriptase inhibitor (NRTI) mutations; 33 (73%) had non-NRTI (NNRTI) mutations; and 30 (66.7%) had both NRTI and NNRTI mutations. Triple-class resistance to NRTIs, NNRTIs, and PR inhibitors was observed in 24 (53%) patients. Based on the mutational profiles observed, all 45 sequences were susceptible to darunavir and tipranavir, whereas 47% showed resistance to lopinavir, 58% showed resistance to atazanavir, and >60% showed resistance to saquinavir, indinavir, nelfinavir, and fosamprenavir. Conclusions. The results of the study showed that the majority of patients receiving second-line antiretroviral therapy started to accumulate PR resistance mutations, and the mutation profiles suggest that darunavir might be the drug of choice for third-line regimens in India.

AB - Background. A cross-sectional study among individuals receiving second-line antiretroviral treatment was conducted to report on the level of detectable viremia and the types of drug resistance mutations among those with detectable human immunodeficiency virus (HIV) type 1 plasma viral loads (PVLs). Methods. PVLs were measured using Abbott m2000rt real-time polymerase chain reaction, and genotyping was performed with the ViroSeq genotyping system, version 2.0, and ViroSeq analysis software, version 2.8.Results.Of 107 patient plasma specimens consecutively analyzed, 30 (28%) had undetectable PVLs (2000 copies/mL: 33 patients (73%) had 1 of the protease (PR) inhibitor mutations; 41 (91%) had nucleoside reverse-transcriptase inhibitor (NRTI) mutations; 33 (73%) had non-NRTI (NNRTI) mutations; and 30 (66.7%) had both NRTI and NNRTI mutations. Triple-class resistance to NRTIs, NNRTIs, and PR inhibitors was observed in 24 (53%) patients. Based on the mutational profiles observed, all 45 sequences were susceptible to darunavir and tipranavir, whereas 47% showed resistance to lopinavir, 58% showed resistance to atazanavir, and >60% showed resistance to saquinavir, indinavir, nelfinavir, and fosamprenavir. Conclusions. The results of the study showed that the majority of patients receiving second-line antiretroviral therapy started to accumulate PR resistance mutations, and the mutation profiles suggest that darunavir might be the drug of choice for third-line regimens in India.

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