Preexisting resistance to nonnucleoside reverse-transcriptase inhibitors predicts virologic failure of an efavirenz-based regimen in treatment-naive HIV-1-infected subjects.

TitlePreexisting resistance to nonnucleoside reverse-transcriptase inhibitors predicts virologic failure of an efavirenz-based regimen in treatment-naive HIV-1-infected subjects.
Publication TypeJournal Article
Year of Publication2008
AuthorsKuritzkes DR, Lalama CM, Ribaudo HJ, Marcial M, Meyer WA, Shikuma C, Johnson VA, Fiscus SA, D'Aquila RT, Schackman BR, Acosta EP, Gulick RM
JournalJ Infect Dis
Volume197
Issue6
Pagination867-70
Date Published2008 Mar 15
ISSN0022-1899
KeywordsAdult, Benzoxazines, Case-Control Studies, Cohort Studies, Drug Administration Schedule, Drug Resistance, Multiple, Viral, Female, HIV Infections, HIV Reverse Transcriptase, HIV-1, Humans, Male, Reverse Transcriptase Inhibitors, Treatment Failure
Abstract

A case-cohort study was used to determine the effect of baseline nonnucleoside reverse-transcriptase inhibitor (NNRTI) resistance, as assessed by viral genotyping, on the response to efavirenz-containing regimens in AIDS Clinical Trials Group A5095. The sample included a random cohort of efavirenz-treated subjects plus unselected subjects who experienced virologic failure. Of 220 subjects in the random cohort, 57 (26%) had virologic failure. The prevalence of baseline NNRTI resistance was 5%. The risk of virologic failure for subjects with baseline NNRTI resistance was higher than that for subjects without such resistance (hazard ratio 2.27 [95% confidence interval], 1.15-4.49; P = .018). These results support resistance testing before starting antiretroviral therapy.

DOI10.1086/528802
Alternate JournalJ. Infect. Dis.
PubMed ID18269317
Grant ListAI027767 / AI / NIAID NIH HHS / United States
AI051966 / AI / NIAID NIH HHS / United States
AI060354 / AI / NIAID NIH HHS / United States
AI06836 / AI / NIAID NIH HHS / United States
AI068636 / AI / NIAID NIH HHS / United States
AI069419 / AI / NIAID NIH HHS / United States
AI069452 / AI / NIAID NIH HHS / United States
AI069472 / AI / NIAID NIH HHS / United States
AI38858 / AI / NIAID NIH HHS / United States
RR024996 / RR / NCRR NIH HHS / United States