@article{fdi:010080919,
  title = {{T}enofovir resistance in early and long-term treated patients on first-line antiretroviral therapy in eight low-income and middle-income countries},
  author = {{I}nzaule, {S}. {C}. and {J}ordan, {M}. {R}. and {C}ournil, {A}mandine and {G}iron-{C}allejas, {A}. and {A}vila-{R}ios, {S}. and {M}ulenga, {L}. and {S}semwanga, {D}. and {A}sio, {J}. and {D}iop-{N}diaye, {H}. and {N}iasse-{T}raore, {F}. and {N}han, {D}. {T}. and {D}at, {V}. {Q}. and {A}ghokeng {F}obang, {A}velin and {B}illong, {S}. and {C}ham, {F}. and {D}oherty, {M}. and {B}ertagnolio, {S}. and {A}cquired {HIV} {D}rug {R}esistance {S}urvey {T}eam,},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective: {W}e aimed to assess the frequency of tenofovir ({TDF}) resistance in people failing tenofovir/lamivudine or emtricitabine ({XTC})/nonnucleotide reverse-transcriptase inhibitor-based first-line antiretroviral treatment ({ART}) using data from 15 nationally representative surveys of {HIV} drug resistance conducted between 2014 and 2018 in {C}ameroon, {G}uatemala, {H}onduras, {N}icaragua, {S}enegal, {U}ganda, {V}ietnam and {Z}ambia. {M}ethods: {P}revalence of nucleoside reverse-transcriptase inhibitor resistance among participants with virological nonsuppression (viral load >= 1000 copies/ml) who had received {TDF}-based {ART} for 12-24 months (early {ART} group) and at least 40 months (long-term {ART} group) was assessed using {S}anger sequencing and resistance was interpreted using the {S}tanford {HIV}db algorithm. {F}or each group, we estimated a pooled prevalence using random effect meta-analysis. {R}esults: {O}f 4677 participants enrolled in the surveys, 640 (13.7%) had virological nonsuppression, 431 (67.3%) were successfully genotyped and were included in the analysis; of those, 60.3% (260) were participants in the early {ART} group. {O}verall, 39.1, 57.9, 38.5 and 3.6% patients in the early {ART} group and 42.9, 69.3, 42.9 and 10.0% patients on long-term {ART} had resistance to {TDF}, {XTC}, {TDF} + {XTC} and {TDF} + {XTC} + zizidovudine, respectively. {O}verall, tenofovir resistance was mainly due to {K}65{R} or {K}70{E}/{G}/{N}/{A}/{S}/{T}/{Y}115{F} mutations (79%) but also due to thymidine analogue mutations (21%) which arise from exposure to thymidine analogues but causing cross-resistance to {TDF}. {C}onclusion: {D}ual resistance to {TDF} + {XTC} occurred in more than 40% of the people with viral nonsuppression receiving tenofovir-based first-line {ART}, supporting {WHO} recommendation to optimize the nucleoside backbone in second-line treatment and cautioning against single drug substitutions in people with unsuppressed viral load.},
  keywords = {early vs. late virological failure ; {HIV} drug resistance ; low-income and ; middle-income countries ; tenofovir-based first-line {HIV} treatment ; {PAYS} {EN} {DEVELOPPEMENT}},
  booktitle = {},
  journal = {{AIDS}},
  volume = {34},
  numero = {13},
  pages = {1965--1969},
  ISSN = {0269-9370},
  year = {2020},
  DOI = {10.1097/qad.0000000000002623},
  URL = {https://www.documentation.ird.fr/hor/fdi:010080919},
}