Low rates of nucleoside reverse transcriptase inhibitor resistance in a well-monitored cohort in South Africa on antiretroviral therapy.

摘要: Background: The emergence of complex HIV-1 drug resistance mutations has been linked to the duration time patients are on a failing antiretroviral regimen. This study reports profiles in closely monitored subtype C infected cohort. Methods: A total 812 participants were enrolled into CIPRA-SA 'safeguard household' study, viral loads determined at 12-weekly intervals for 96 weeks. Virological failure was defined as either 1,000 RNA copies/ml after week 24. Regimens prescribed line with South African roll-out programme (stavudine, lamivudine, efavirenz or nevirapine). Viral extracted from virological failure, and pol reverse-transcriptase PCR sequence analysis performed determine drug-resistant mutations. Results: observed 83 first-line regimen during period, which 61 (73%) had M184V mutation most frequent (n=46; 65%), followed by K103N (46%) Y181C (21%). Thymidine analogue infrequent (1%) Q151M not observed. Conclusions: Drug less than previously reported Africa using same regimens. These data suggest that load monitoring limits level complexity C, preserving susceptibility second-line options.