ArticleThe Journal of antimicrobial chemotherapy2016
High prevalence of PI resistance in patients failing second-line ART in Vietnam.
Article in The Journal of antimicrobial chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Second-line HIV treatment failure in sub-Saharan Africa: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Effectiveness of Protease Inhibitor/Nucleos(t)ide Reverse Transcriptase Inhibitor-Based Second-line Antiretroviral Therapy for the Treatment of Human Immunodeficiency Virus Type 1 Infection in Sub-Saharan Africa: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Pooled it
- Experience in Diagnostic of HIV Drug Resistance in the Mekong Delta Region, Vietnam: A Comparative Analysis Before and After the COVID-19 Pandemic.Diagnostics (Basel, Switzerland) · 2025Article
- Development of HIV Drug-Resistance Mutations and Antiretroviral Efficacy Among Vietnamese Patients After Failure of 5-Year First-Line Therapy.Journal of clinical laboratory analysis · 2025Observational
- Virological failure and HIV drug resistance among adults living with HIV on second-line antiretroviral therapy in the Asia-Pacific.HIV medicine · 2021Article
- A retrospective descriptive investigation of adult patients receiving third-line antiretroviral therapy in the North West province, South Africa.African health sciences · 2020Article
- Antiretroviral drug resistance mutations among patients failing first-line treatment in Hanoi, Vietnam.Infection and drug resistance · 2019Article
- HIV-1 second-line failure and drug resistance at high-level and low-level viremia in Western Kenya.AIDS (London, England) · 2018Article
- Indinavir Alters the Pharmacokinetics of Lamivudine Partially via Inhibition of Multidrug and Toxin Extrusion Protein 1 (MATE1).Pharmaceutical research · 2018Article
- Positive Virological Outcomes of HIV-Infected Patients on Protease Inhibitor-Based Second-Line Regimen in Cambodia: The ANRS 12276 2PICAM Study.Frontiers in public health · 2018Article
- HIV drug resistance testing among patients failing second line antiretroviral therapy. Comparison of in-house and commercial sequencing.Journal of virological methods · 2017Article
- High rate of HIV-1 drug resistance in treatment failure patients in Taiwan, 2009-2014.Infection and drug resistance · 2017Article
- Long-term outcomes of second-line antiretroviral treatment in an adult and adolescent cohort in Myanmar.Global health action · 2017Article
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Authors and funding
10 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundThere are limited data from resource-limited settings on antiretroviral resistance mutations that develop in patients failing second-line PI ART.
methodsWe performed a cross-sectional virological assessment of adults on second-line ART for ≥6 months between November 2006 and December 2011, followed by a prospective follow-up over 2 years of patients with virological failure (VF) at the Hospital for Tropical Diseases, Vietnam. VF was defined as HIV RNA concentrations ≥1000 copies/mL. Resistance mutations were identified by population sequencing of the pol gene and interpreted using the 2014 IAS-USA mutation list and the Stanford algorithm. Logistic regression modelling was performed to identify predictors of VF.
resultsTwo hundred and thirty-one patients were enrolled in the study. The median age was 32 years; 81.0% were male, 95.7% were on a lopinavir/ritonavir-containing regimen and 22 (9.5%) patients had VF. Of the patients with VF, 14 (64%) carried at least one major protease mutation [median: 2 (IQR: 1-3)]; 13 (59%) had multiple protease mutations conferring intermediate- to high-level resistance to lopinavir/ritonavir. Mutations conferring cross-resistance to etravirine, rilpivirine, tipranavir and darunavir were identified in 55%, 55%, 45% and 27% of patients, respectively. Higher viral load, adherence <95% and previous indinavir use were independent predictors of VF. The 2 year outcomes of the patients maintained on lopinavir/ritonavir included: death, 7 (35%); worsening virological/immunological control, 6 (30%); and virological re-suppression, 5 (25%). Two patients were switched to raltegravir and darunavir/ritonavir with good HIV control.
conclusionsHigh-prevalence PI resistance was associated with previous indinavir exposure. Darunavir plus an integrase inhibitor and lamivudine might be a promising third-line regimen in Vietnam.
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