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Treatment-emergent reverse transcriptase resistance during antiretroviral therapy with bictegravir, tenofovir alafenamide, and emtricitabine: A case series.
DeKoven, Samuel; Naccarato, Mark; Brumme, Chanson J; Tan, Darrell H S.
Afiliação
  • DeKoven S; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
  • Naccarato M; Department of Pharmacy, Henry Ford Hospital, Detroit, Michigan, USA.
  • Brumme CJ; BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
  • Tan DHS; Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia, Canada.
HIV Med ; 24(11): 1137-1143, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37317505
OBJECTIVES: Bictegravir/tenofovir alafenamide/emtricitabine (BIC/TAF/FTC) is a complete regimen for the treatment of HIV with a high barrier to resistance and few reported cases of treatment failure. We present three cases of treatment-emergent resistance to nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) in patients with suboptimal treatment adherence and assess whether the resistance-associated mutations were present before BIC/TAF/FTC initiation or emerged during therapy. METHODS: We used genotypic drug resistance testing by Sanger sequencing to identify emergent resistance mutations in plasma viral load specimens collected after combination antiretroviral therapy initiation in all participants. Additionally, we performed ultra-deep sequencing by Illumina MiSeq on the earliest available plasma HIV-1 viral load specimen and on any available specimens closest in time to the initiation of BIC/TAF/FTC therapy to identify low-abundance resistance mutations present in the viral quasispecies. RESULTS: All three participants developed NRTI resistance after prolonged exposure and incomplete adherence to BIC/TAF/FTC. The T69N, K70E, M184I, and/or T215I mutations identified in clinical samples at the time of virological failure were not present on deep sequencing of either baseline samples or samples collected before BIC/TAF/FTC initiation. CONCLUSIONS: Despite a generally high genetic barrier to resistance, NRTI resistance-associated mutations may emerge during therapy with BIC/TAF/FTC in the setting of suboptimal adherence.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Fármacos Anti-HIV Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Fármacos Anti-HIV Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article