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http://hdl.handle.net/2445/134539
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DC Field | Value | Language |
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dc.contributor.author | Inzaule, Seth C. | - |
dc.contributor.author | Kityo, Cissy M. | - |
dc.contributor.author | Siwale, Margaret | - |
dc.contributor.author | Akanmu, Alani Sulaimon | - |
dc.contributor.author | Wellington, Maureen | - |
dc.contributor.author | Jager, Marleen de | - |
dc.contributor.author | Ive, Prudence | - |
dc.contributor.author | Mandaliya, Kishor | - |
dc.contributor.author | Stevens, Wendy | - |
dc.contributor.author | Boender, T. Sonia | - |
dc.contributor.author | Ondoa, Pascale | - |
dc.contributor.author | Sigaloff, Kim C. E. | - |
dc.contributor.author | Naniche, Denise | - |
dc.contributor.author | Rinke de Wit, Tobias F. | - |
dc.contributor.author | Hamers, Raph L. | - |
dc.date.accessioned | 2019-06-04T12:02:24Z | - |
dc.date.available | 2019-06-04T12:02:24Z | - |
dc.date.issued | 2018-10-25 | - |
dc.identifier.issn | 2045-2322 | - |
dc.identifier.uri | http://hdl.handle.net/2445/134539 | - |
dc.description.abstract | In ART programs in sub-Saharan Africa, a growing proportion of HIV-infected persons initiating first-line antiretroviral therapy (ART) have a history of prior antiretroviral drug use (PAU). We assessed the effect of PAU on the risk of pre-treatment drug resistance (PDR) and virological failure (VF) in a multicountry cohort of HIV-infected adults initiated on a standard non-nucleoside reverse transcriptase inhibitor (NNRTI)-based first-line ART. Multivariate logistic regression was used to assess the associations between PAU, PDR and VF (defined as viral load ≥400 cps/mL). Causal mediation analysis was used to assess the proportion of the effect of PAU on VF that could be eliminated by intervening on PDR. Of 2737 participants, 122 (4.5%) had a history of PAU. Participants with PAU had a 7.2-fold (95% CI 4.4–11.7) risk of carrying PDR and a 3.1-fold (95% CI 1.6–6.1) increased risk of VF, compared to antiretroviral-naïve participants. Controlling for PDR would eliminate nearly half the effect of PAU on the risk of VF. Patients with a history of PAU are at increased risk of ART failure, which is to a large extent attributable to PDR. These findings support the recent WHO recommendations for use of differentiated, non-NNRTI-based empiric first-line therapy in patients with PAU. | - |
dc.format.extent | 7 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Nature Publishing Group | - |
dc.relation.isformatof | Reproducció del document publicat a: http://dx.doi.org/ 10.1038/s41598-018-33538-0 | - |
dc.relation.ispartof | Scientific Reports, 2018, vol. 8 | - |
dc.relation.uri | http://dx.doi.org/ 10.1038/s41598-018-33538-0 | - |
dc.rights | cc by (c) Inzaule et al., 2018 | - |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es/ | - |
dc.source | Articles publicats en revistes (ISGlobal) | - |
dc.subject.classification | Infeccions per VIH | - |
dc.subject.classification | Àfrica subsahariana | - |
dc.subject.classification | Antiretrovirals | - |
dc.subject.other | HIV infections | - |
dc.subject.other | Sub-Saharan Africa | - |
dc.subject.other | Antiretroviral agents | - |
dc.title | Previous antiretroviral drug use compromises standard first-line HIV therapy and is mediated through drug-resistance | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.date.updated | 2019-05-27T08:59:05Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 30361640 | - |
Appears in Collections: | Articles publicats en revistes (ISGlobal) |
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File | Description | Size | Format | |
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Inzaule_SC_Sci_Rep_2018.pdf | 1.1 MB | Adobe PDF | View/Open |
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