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Prevalence of doravirine cross-resistance in HIV-infected adults who failed first-line ART in China, 2014-18.
Sun, Zhuoqun; Lan, Yun; Liang, Shujia; Wang, Jing; Ni, Mingjian; Zhang, Xia; Yu, Fengting; Chen, Meiling; Zhang, Hanxi; Yan, Liting; Cai, Weiping; Lan, Guanghua; Ma, Ye; Zhang, Fujie.
Afiliação
  • Sun Z; Peking University Ditan Teaching Hospital, Beijing, China.
  • Lan Y; Capital Medical University Affiliated Beijing Ditan Hospital, Beijing, China.
  • Liang S; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Wang J; Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China.
  • Ni M; Chongqing Public Health Medical Center, Chongqing, China.
  • Zhang X; Xinjiang Center for Disease Control and Prevention, Xinjiang, China.
  • Yu F; Medical Laboratory Science Department of Weifang Medical College, Shandong, China.
  • Chen M; Capital Medical University Affiliated Beijing Ditan Hospital, Beijing, China.
  • Zhang H; Capital Medical University Affiliated Beijing Ditan Hospital, Beijing, China.
  • Yan L; Capital Medical University Affiliated Beijing Ditan Hospital, Beijing, China.
  • Cai W; Capital Medical University Affiliated Beijing Ditan Hospital, Beijing, China.
  • Lan G; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Ma Y; Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China.
  • Zhang F; National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
J Antimicrob Chemother ; 77(4): 1119-1124, 2022 03 31.
Article em En | MEDLINE | ID: mdl-35134966
OBJECTIVES: To evaluate the prevalence and characteristics of doravirine resistance and cross-resistance in patients who failed first-line ART in China. METHODS: From 2014 to 2108, 4132 patients from five provinces were tested for drug resistance by genotypic resistance testing. Drug resistance mutations were assessed using the Stanford HIVdb algorithm Version 9.0. Sequences classified as having low-level, intermediate and high-level resistance were defined as having drug resistance. RESULTS: Overall, the prevalence of doravirine and other NNRTIs cross-resistance was 69.5%, with intermediate and high-level resistance accounting for 56.4%. Doravirine resistance highly correlated with efavirenz (r = 0.720) and nevirapine (r = 0.721) resistance and moderately correlated with etravirine (r = 0.637) and rilpivirine (r = 0.692) resistance. The most frequent doravirine-associated resistance mutations were V106M (8.7%), K101E (6.8%) and P225H (5.1%). High-level resistance was mainly due to Y188L (3.2%) and M230L (2.7%). There were significant differences between genotypes and provinces. Compared with CRF01_AE, CRF07_BC (OR = 0.595, 95% CI = 0.546-0.648) and CRF08_BC (OR = 0.467, 95% CI = 0.407-0.536) were associated with lower risks of doravirine resistance. Conversely, genotype A (OR = 3.003, 95% CI = 1.806-4.991) and genotype B (OR = 1.250, 95% CI = 1.021-1.531) were associated with higher risks of doravirine resistance. The risk of doravirine resistance was significantly lower in Xinjiang compared with other provinces. CONCLUSIONS: In China, the prevalence of doravirine cross-resistance among patients who have failed first-line ART is high. Therefore, doravirine should not be used blindly without genotypic resistance testing and is not recommended for people who have failed first-line NNRTI-based ART.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / HIV-1 / Fármacos Anti-HIV Tipo de estudo: Prevalence_studies / Risk_factors_studies Limite: Adult / Humans País/Região como assunto: Asia Idioma: En Revista: J Antimicrob Chemother Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / HIV-1 / Fármacos Anti-HIV Tipo de estudo: Prevalence_studies / Risk_factors_studies Limite: Adult / Humans País/Região como assunto: Asia Idioma: En Revista: J Antimicrob Chemother Ano de publicação: 2022 Tipo de documento: Article