Accumulation of HIV drug resistance mutations in patients failing first-line antiretroviral treatment in South Africa

Kim C E Sigaloff, Tina Ramatsebe, Raquel Viana, Tobias F Rinke De Wit, Carole L. Wallis, Wendy S. Stevens

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Patients failing antiretroviral treatment for extended periods of time are at risk of accumulating HIV drug resistance mutations (DRMs), which negatively influences second-line treatment. This retrospective study assessed the rate of DRM accumulation among South African patients with continued virological failure. Serial genotypic resistance testing was performed and DRMs were scored according to the 2009 IAS-USA list. Among 43 patients, 38 (88.4%) harbored ≥1 DRM. The median time between two sequential resistance tests was 5 months (IQR: 3-10). Thymidine analogue mutations accumulated at a rate of 0.07 mutation per month of drug exposure, which is faster than previously reported. Routine virological monitoring should be implemented in resource-limited settings to preserve susceptibility to second-line regimens.

Original languageEnglish
Pages (from-to)171-175
Number of pages5
JournalAIDS Research and Human Retroviruses
Issue number2
Publication statusPublished - 1 Feb 2012

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