First publication from EuroCoord-CHAIN project
Data from EuroCoord were used in an analysis which investigated
the effect of Transmitted Drug Resistance (TDR) on outcome in the
first year of combination antiretroviral therapy (cART).
The study found that Transmitted Drug Resistance (TDR) was
associated with virological failure in patients who received at
least one drug to which the virus had lost susceptibility. The
group also found that treatment with a drug classified even with
low-level resistance is associated with a significantly higher risk
for virological failure, emphasising the need for at least three
fully-active drugs in a first-line regimen.
A further finding of the study showed that patients with TDR who
started a regimen containing two NRTIs plus one ritonavir-boosted
protease inhibitor and received fully-active treatment, had a
similar risk of virological failure to patients with a virus with
no TDR mutations. Therefore, if drug resistance mutations are
detected before treatment initiation, a ritonavir-boosted protease
inhibitor can be included in the first treatment regimen, which,
because of its higher genetic barrier, could better protect from
the risk of virological failure than could NNRTI.
Wittkop L, Günthard H, de Wolf F, Dunn D, Cozzi-Lepri A, de
Luca A, Kücherer C, Obel N, von Wyl V, Masquelier B, Stephan C,
Torti C, Antinori A, García F, Judd A, Porter K, Thiébaut R, Castro
H, van Sighem AI, Colin C, Kjaer J, Lundgren JD, Paredes R, Pozniak
A, Clotet B, Phillips A, Pillay D, Chêne G, for the EuroCoord-CHAIN
study group. Effect of transmitted drug resistance on virological
and immunological response to initial combination antiretroviral
therapy for HIV (EuroCoord-CHAIN joint project): a European
multicohort study. Lancet Infect. Dis. 2011. [Epub ahead of
print]
Find out more about the
EuroCoord-CHAIN project