Table 1.
Clinical and Virological Characteristics of the Patients in the Study
| Subtype no. (%) | |||||||
|---|---|---|---|---|---|---|---|
| Group of patientsa | cART regimen (no. patients)b | Mean HIV-1 RNA log10 c/mlc | A | D | C | A/D | Otherd |
| cART naive (n = 87) | None | 4.64 | 42 (47.1) | 17 (19.5) | 3 (3.4) | 9 (10.3) | 17 (19.5) |
| Failing first-line cART (n = 158) | AZT, 3TC, NVP (38) | 0.54 | 14 (36.9) | 11 (28.9) | 4 (10.5) | 2 (5.3) | 7 (18.4) |
| TDF, 3TC, EFV (34) | 1.21 | 14 (41.2) | 10 (29.4) | 2 (5.9) | 1 (2.9) | 7 (20.6) | |
| AZT, 3TC, EFV (18) | 1.31 | 18 (44.4) | 6 (33.3) | 1 (5.6) | 1 (5.6) | 2 (11.1) | |
| TDF, 3TC, FTC (15) | 0.43 | 1 (20) | 1 (20) | 1 (20) | 0 (0.0) | 2 (40) | |
| Other (14) | 7.5 | 5 (35.7) | 5 (35.7) | 2 (14.3) | 2 (14.3) | 0 (0.0) | |
| 3TC, D4T, NVP (13) | 2.2 | 8 (61.5) | 1 (7.7) | 0 (0.0) | 1 (7.7) | 3 (23.1) | |
| ABC, 3TC, NVP (10) | 2.56 | 4 (40) | 1 (10) | 1 (10) | 1 (10) | 3 (30) | |
| ABC, 3TC, EFV (7) | 0.64 | 7 (100) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| TDF, 3TC, NVP (6) | 0.97 | 0 (0.0) | 3 (50) | 0 (0.0) | 1 (16.7) | 2 (33.3) | |
| 3TC, AZT, NVP (4) | 2.22 | 0 (0.0) | 1 (25) | 1 (25) | 1 (25) | 1 (25) | |
| d4T, 3TC, NVP (3) | 0.97 | 0 (0.0) | 3 (100) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| AZT, 3TC, ABC (2) | ND | 0 (0.0) | 1 (50) | 0 (0.0) | 0 (0.0) | 1 (50) | |
| FTC, TDF, EFV (2) | 0.7 | 1 (50) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (50) | |
| TDF, ABC, AZT (2) | ND | 1 (50) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (50) | |
| Failing second-line cART (n = 121) | TDF, 3TC, LPVr (30) | 1.22 | 13 (43.3) | 4 (13.3) | 2 (6.7) | 2 (6.7) | 9 (30) |
| TDF, 3TC, ATVr (30) | 2.2 | 14 (46.7) | 7 (23.3) | 1 (3.3) | 2 (6.7) | 6 (20) | |
| ABC, 3TC, LPVr (25) | 2.13 | 12 (48) | 8 (32) | 1 (4) | 0 (0.0) | 4 (16) | |
| ABC, 3TC, ATVr (25) | 3.64 | 3 (60) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (40) | |
| AZT, 3TC, LPVr (13) | 7.82 | 4 (30.7) | 3 (23.1) | 0 (0.0) | 3 (23.1) | 3 (23.1) | |
| LPVr (7) | 0.05 | 3 (42.9) | 4 (57.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| AZT, 3TC, ATVr (6) | 2.53 | 4 (66.7) | 2 (33.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Other (5) | 0.7 | 1 (20) | 1 (20) | 0 (0.0) | 1 (20) | 2 (40) | |
| Failing RAL-based cART (n = 51) | RAL, LPVr (28) | 3.1 | 15 (53.5) | 7 (25.0) | 1 (3.5) | 3 (10.7) | 2 (7.1) |
| Other (3) | 0.3 | 2 (67.0) | 1 (33.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| RAL, DRVr (6) | 6.4 | 5 (83.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (16.6) | |
| RAL, ATVr (2) | 8.5 | 1 (50) | 1 (50) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| RAL, TDF, 3TC, LPVr (3) | 2.7 | 3 (100) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| TDF, 3TC, RAL, DRVr (7) | 1.6 | 5 (71.4) | 2 (28.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| RAL, ETR, DRVr (2) | 1.1 | 2 (100) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
The HIV subtype was predicted using SCUEAL subtype classification algorithm. Viral loads were assayed using Abbott m2000sp/rt or Roche COBAS Amplicor Monitor ultrasensitive tests, v1.5.
The total number of patients tested for INSTI resistance in each patient group.
Description of the ART combinations in the study, and the number of patients taking that combination. Other, the number of ART combinations, which were less prescribed, that is, only one patient for each of these ART drug combinations: (3TC, TDF, NVP) (AZT, D4T, 3TC, NVP) (3TC, EFV, LPVr) (3TC, EFV, ATVr) (ABC, DDI, LPVr) (TDF, 3TC, ATVr) (EFV, DDI, LPVr) (EFV, RAL, DRVr) (TDF,3TC, RAL, ETR) (TDF, FTC, RAL, DRVr) (RAL, ETR, LPVr).
The average number of patient viral loads (copies/ml × 105).
The percentage of patients with HIV-1 unique circulating recombinant forms (CRFs); A1/C, A1/AE, D/U, J/A1,C/G, AE/D, A1/U, A3/U, and CRF35. Until the time ATVr was available and incorporated into national treatment guidelines, LPVr was infrequently provided as second-line monotherapy if resistance patient had drug resistance to 3TC and AZT.
cART, combined antiretroviral therapy; ND, not determined; INSTI, integrase strand transfer inhibitor; ART, antiretroviral therapy; ABC, abacavir; AZT, zidovudine; D4T, stavudine; DDI, didanosine; FTC, emtricitabine; 3TC, lamivudine; TDF, tenofovir; EFV, efavirenz; ETR, etravirine; NVP, nevirapine; RPV, rilpivirine; ATVr, atazanavir/r; DRVr, darunavir/r; FPVr, fosamprenavir/r; IDVr, indinavir/r; LPVr, lopinavir/r; NFV, nelfinavir; SQVr, saquinavir/r; TPVr, tipranavir /r; DTG, dolutegravir; EVG, elvitegravir; RAL, raltegravir.