Rapid accumulation of nonnucleoside reverse transcriptase inhibitor-associated resistance: evidence of transmitted resistance in rural South Africa

• DOI: 10.1097/qad.0b013e328313bf87
• Publication Date: 2008-10-02T07:09:47Z
• Authors: Roos E Barth; Annemarie M Wensing; Hugo A Tempelman; Robert Moraba; Rob Schuurman; Andy I Hoepelman
• Keywords: Reverse-transcriptase inhibitor; Thymidine

In a large cohort in rural South Africa, 73% of subtype-C-infected patients initiating highly active antiretroviral therapy achieved viral suppression. with subsequent virological failure, an unexpected, rapid accumulation nonnucleoside reverse transcriptase inhibitor-associated mutations was observed, whereas no thymidine analogue-associated emerged. It appeared that several had drug-associated prior to starting antiretrovirals, suggesting transmission resistance may have contributed the inhibitor-mutations. Importantly, monitoring HIV-RNA and prompt switch treatment prevent development mutations.