Transmitted Drug Resistance in HIV: Prevalence and Clinical Effects
Author Information
Author(s): Poon Art F. Y., Aldous Jeannette L., Mathews W. Christopher, Kitahata Mari, Kahn James S., Saag Michael S., Rodríguez Benigno, Boswell Stephen L., Frost Simon D. W., Haubrich Richard H.
Primary Institution: BC Centre for Excellence in HIV/AIDS
Hypothesis
The presence of transmitted drug resistance (TDR) mutations in therapy-naïve hosts has a measurable effect on the subsequent rate of growth of the virus population and the depletion of CD4+ T-lymphocytes.
Conclusion
Transmitted drug resistance mutations significantly affect baseline CD4 counts and plasma viral load in therapy-naïve HIV patients.
Supporting Evidence
- The overall prevalence of transmitted drug resistance was found to be 14.2%.
- Transmitted resistance to reverse transcriptase inhibitors was significantly associated with lower CD4 counts.
- Position-specific analyses revealed substantial effects on CD4 and viral load at several residue positions.
Takeaway
Some people who get HIV already have a virus that is resistant to medicine, which can make it harder for doctors to treat them.
Methodology
The study analyzed data from a multi-center cohort of therapy-naïve HIV patients, assessing the prevalence of transmitted drug resistance mutations and their effects on CD4 and viral load.
Potential Biases
Potential confounding factors include demographic variables and other co-transmitted resistance mutations that could affect outcomes.
Limitations
The study population was comprised of seroprevalent individuals, and baseline measurements of CD4 and viral load were taken at varying times post-infection, which may introduce bias.
Participant Demographics
The majority of participants self-reported as white, with a median age of 1964; 3725 identified as black, 207 as Asian/Pacific Islander, and 835 as other.
Statistical Information
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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