@article{fdi:010060627,
  title = {{I}ncreased risk of {Q}151{M} and {K}65{R} mutations in patients failing stavudine-containing first-line antiretroviral therapy in {C}ambodia},
  author = {{N}ouhin, {J}. and {M}adec, {Y}. and {N}go-{G}iang-{H}uong, {N}icole and {F}erradini, {L}. and {N}errienet, {E}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {M}ulti-nucleos(t)ide resistance ({MNR}) mutations including {Q}151{M}, {K}65{R} mutations, and insertion at codon 69 of {HIV}-1 reverse transcriptase coding region may confer resistance to all molecules of nucleos(t)ide reverse transcriptase inhibitors ({NRTI}). {T}he presence of these mutations is an emerging problem compromising non-nucleoside reverse transcriptase inhibitors and protease inhibitors-based therapies. {F}urthermore, factors associated with selection of these mutations are still not well defined. {T}he current study aimed to evaluate the frequency and to characterize factors associated with the occurrence of multi-nucleos(t)ide resistance mutations among {HIV}-1 infected patients failing recommended first-line antiretroviral regimens in {C}ambodia. {M}ethodology/{P}rincipal {F}inding: {T}his is a retrospective analysis of {HIV}-1 drug resistance genotyping of 520 {HIV}-1 infected patients in virological failure (viral load > 250 copies/m{L}) while on first-line antiretroviral therapy in {C}ambodia with at least one reverse transcriptase inhibitor resistance associated mutation. {A}mong these 520 patients, a total of 66 subjects (66/520, 12.7%) presented >= 1 {MNR} mutation, including {Q}151{M}, {K}65{R}, and {I}nsert69 for 59 (11.3%), 29 (5.6%), and 2 (0.4%) patients, respectively. {I}n multivariate analysis, both {Q}151{M} (p = 0.039) and {K}65{R} (p = 0.029) mutations were independently associated with current stavudine-compared to zidovudine-use. {C}onclusion: {S}uch selection of mutations by stavudine drastically limits the choice of antiretroviral molecules available for second-line therapy in resource-limited settings. {T}his finding supports the {W}orld {H}ealth {O}rganization's recommendation for stavudine phase-out.},
  keywords = {{CAMBODGE}},
  booktitle = {},
  journal = {{P}lo{S} {O}ne},
  volume = {8},
  numero = {8},
  pages = {art. e73744},
  ISSN = {1932-6203},
  year = {2013},
  DOI = {10.1371/journal.pone.0073744},
  URL = {https://www.documentation.ird.fr/hor/fdi:010060627},
}