@article{fdi:010072771,
  title = {{N}ucleoside reverse transcriptase inhibitors with reduced predicted activity do not impair second-line therapy with lopinavir/ritonavir or darunavir/ritonavir},
  author = {{V}illabona-{A}renas, {C}. {J}. and {E}ymard-{D}uvernay, {S}abrina and {A}ghokeng {F}obang, {A}velin and {G}uichet, {E}. and {T}oure-{K}ane, {C}. and {B}ado, {G}. and {K}oulla-{S}hiro, {S}. and {D}elaporte, {E}. and {C}iaffi, {L}. and {P}eeters, {M}artine},
  editor = {},
  language = {{ENG}},
  abstract = {{S}econd-line therapy randomized trials with lopinavir/ritonavir question the value of resistance testing to guide nucleoside reverse transcriptase inhibitor ({NRTI}) selection. {I}n this study, we investigated the association between baseline drug resistance and treatment outcome after 104 weeks of second-line therapy with {NRTI}s and either darunavir/ritonavir or lopinavir/ritonavir in {W}est-central {A}frica. {W}e did an observational analysis of data from 387 individuals in a randomized, open-label 2{LADY} trial in {B}urkina {F}aso, {C}ameroon, and {S}enegal. {W}e modeled the association between {RTI} drug resistance mutations ({DRM}s) and virological failure ({VF}) (viral load [{VL}] <50 copies/m{L}) at week 104 using logistic regressions. {C}ovariates included baseline {VL} and {CD}4(+) count, demographic, and adherence data. {O}verall, 193 (49.9%), 150 (38.8%), and 44 (11.4%) individuals had, respectively, low/none (genotypic susceptibility score [{GSS}] <1), intermediate ({GSS}=1), and high predicted {NRTI} activity ({GSS} >1) in their prescribed second-line regimen. {T}he average number of {DRM}s by drug class, the proportion of individuals by {GSS} category, and the duration of first-line therapy were not associated with {VF} (p>.05). {H}igh {VL} at switch was the only consistent prognostic factor for {VF} after multivariate adjustment (p<.01). {S}uboptimal adherence, high predicted {RTI} activity, or low {NRTI} mutations were associated with {VF} (p<.05) when using higher end points for {VF} or in the intention-to-treat analysis. {I}n conclusion, the use of {RTI}s with predicted reduced activity does not impair second-line protease inhibitor-based therapy. {T}herefore, {HIV} care in resource-limited settings should prioritize strategies to improve adherence and targeted {VL} testing over drug resistance testing for selecting {NRTI}s during a protease-based second-line switch.},
  keywords = {{HIV} drug resistance ; {W}est {A}frica ; second line therapy ; darunavir ; resistance testing ; {BURKINA} {FASO} ; {SENEGAL} ; {CAMEROUN}},
  booktitle = {},
  journal = {{A}ids {R}esearch and {H}uman {R}etroviruses},
  volume = {{E}head of print},
  numero = {},
  pages = {4},
  ISSN = {0889-2229},
  year = {2018},
  DOI = {10.1089/aid.2017.0290},
  URL = {https://www.documentation.ird.fr/hor/fdi:010072771},
}