ArticleBMC infectious diseases2012
Virologic versus immunologic monitoring and the rate of accumulated genotypic resistance to first-line antiretroviral drugs in Uganda.
Article in BMC infectious diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Pooled it
- Trial
- Cumulative viral load as a predictor of CD4+ T-cell response to antiretroviral therapy using Bayesian statistical models.PloS one · 2019Article
- Evolution of HIV-1 drug resistance after virological failure of first-line antiretroviral therapy in Lusaka, Zambia.Antiviral therapy · 2019Article
- Results of Early Virologic Monitoring May Facilitate Differentiated Care Monitoring Strategies for Clients on ART, Rakai, Uganda.Open forum infectious diseases · 2018Article
- High levels of viral suppression among East African HIV-infected women and men in serodiscordant partnerships initiating antiretroviral therapy with high CD4 counts and during pregnancy.AIDS research and human retroviruses · 2018Article
- Antiretroviral resistance following immunological monitoring in a resource-limited setting of western India: A cross-sectional study.PloS one · 2017Article
- HIV virological failure and drug resistance in a cohort of Tanzanian HIV-infected adults.The Journal of antimicrobial chemotherapy · 2016Article
- Brief Report: Virologic Monitoring Can Be a Cost-Effective Strategy to Diagnose Treatment Failure on First-Line ART.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Article
- Detection of immunological treatment failure among HIV infected patients in Ethiopia: a retrospective cohort study.BMC immunology · 2015Article
- Is CD4 monitoring needed among ugandan clients achieving a virologic and immunologic response to treatment?AIDS patient care and STDs · 2014Article
- Cost-effectiveness of different strategies to monitor adults on antiretroviral treatment: a combined analysis of three mathematical models.The Lancet. Global health · 2014Article
- Treatment failure and drug resistance is more frequent in HIV-1 subtype D versus subtype A-infected Ugandans over a 10-year study period.AIDS (London, England) · 2013Article
- Emergence of HIV drug resistance during first- and second-line antiretroviral therapy in resource-limited settings.The Journal of infectious diseases · 2013Review
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundViral load monitoring (VLM) to identify individuals failing antiretroviral therapy (ART) is not widely available in resource-limited settings. We compared the genotypic resistance patterns between clients with VLM versus immunological monitoring (IM).
methodsBetween 2004-2008, 559 ART naïve clients were enrolled in a prospective cohort, initiated on ART, and monitored with viral load (VL) and CD4+ cell counts every 6 months (VLM group). From February 2008 through June 2009, 998 clients on ART for 36-40 months (corresponding to the follow-up time of the VLM group) at the same clinic and monitored with CD4+ cell counts every 6 months were recruited into a cross sectional study (IM group). Samples from VLM clients at 12, 24 and 36 months and IM clients at 36-40 months with VL > 2000 copies/ml underwent genotypic drug resistance testing.
resultsBaseline characteristics were similar. Virologic failure (VL > 400 copies/ml) at 12, 24 and 36 months in the VLM group were 12%, 6% and 8% respectively, and in the IM group 10% at 36-40 months. Samples from 39 VLM and 70 IM clients were genotyped. 23/39 (59%) clients in the VLM group (at 12, 24 or 36 months) compared to 63/70 (90%) in the IM group, (P < 0.0001) had at least 1 non-nucleoside reverse transcriptase mutation. 19/39 (49%) of VLM clients had an M184V mutation compared to 61/70 (87%) in the IM group (P < 0.0001). Only 2/39 (5%) of VLM clients developed thymidine analogue mutations compared to 34/70 (49%) of IM clients (P < 0.0001).
conclusionsRoutine VL monitoring reduced the rate of accumulated genotypic resistance to commonly used ART in Uganda.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.