Evidence map›Paper›PMID 29800305›Full record

ArticleThe Journal of antimicrobial chemotherapy2018

High discordance in blood and genital tract HIV-1 drug resistance in Indian women failing first-line therapy.

Shanmugam Saravanan, Selvamurthi Gomathi, Allison Delong, Bagavathi Kausalya, Sathasivam Sivamalar, Selvamuthu Poongulali, Katherine Brooks, Nagalingeswaran Kumarasamy, Pachamuthu Balakrishnan, Sunil S Solomon and 2 more

Open access · bronzeAbstract read
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 95% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Shanmugam SaravananYRG Centre for AIDS Research and Education, Chennai, India.
Selvamurthi GomathiYRG Centre for AIDS Research and Education, Chennai, India.
Allison DelongBrown University, Providence, RI, USA.
Bagavathi KausalyaYRG Centre for AIDS Research and Education, Chennai, India.
Sathasivam SivamalarYRG Centre for AIDS Research and Education, Chennai, India.
Selvamuthu PoongulaliYRG Centre for AIDS Research and Education, Chennai, India.
Katherine BrooksBrown University, Providence, RI, USA.
Nagalingeswaran KumarasamyYRG Centre for AIDS Research and Education, Chennai, India.
Pachamuthu BalakrishnanYRG Centre for AIDS Research and Education, Chennai, India.
Sunil S SolomonYRG Centre for AIDS Research and Education, Chennai, India.
Susan Cu-UvinBrown University, Providence, RI, USA.
Rami KantorBrown University, Providence, RI, USA.
YR Gaitonde Centre for AIDS Research and Education · INBrown University · USJohns Hopkins University · US

Funding

Translational ScienceP30AI042853 · NIAID · MIRIAM HOSPITAL · PI LARRY K BROWN · 1998 to 2026
$51.7M
Miriam/Brown/Tufts Fogarty AIDS International Training and Research ProgramD43TW000237 · FIC · MIRIAM HOSPITAL · PI CU-UVIN, SUSAN · 1993 to 2014
$10.6M
Optimizing HIV Treatment Monitoring under Resource ConstraintsR01AI108441 · NIAID · BROWN UNIVERSITY · PI HOGAN, JOSEPH W, KANTOR, RAMI · 2015 to 2019
$3.5M
FIC NIH HHS D43 TW000237NIAID NIH HHS P30 AI042853NIAID NIH HHS R01 AI108441
6 · The paper itself

Abstract

Objectives: Examine HIV-1 plasma viral load (PVL) and genital tract (GT) viral load (GVL) and drug resistance in India. Methods: At the YRG Centre for AIDS Research and Education, Chennai, we tested: PVL in women on first-line ART for ≥6 months; GVL when PVL >2000 copies/mL; and plasma, genital and proviral reverse transcriptase drug resistance when GVL >2000 copies/mL. Wilcoxon rank-sum and Fisher's exact tests were used to identify failure and resistance associations. Pearson correlations were calculated to evaluate PVL-GVL associations. Inter-compartmental resistance discordance was evaluated using generalized estimating equations. Results: Of 200 women, 37% had detectable (>400 copies/mL) PVL and 31% had PVL >1000 copies/mL. Of women with detectable PVL, 74% had PVL >2000 copies/mL, of which 74% had detectable GVL. Higher PVL was associated with higher GVL. Paired plasma and genital sequences were available for 21 women; mean age of 34 years, median ART duration of 33 months, median CD4 count of 217 cells/mm3, median PVL of 5.4 log10 copies/mL and median GVL of 4.6 log10 copies/mL. Drug resistance was detected in 81%-91% of samples and 67%-76% of samples had dual-class resistance. Complete three-compartment concordance was seen in only 10% of women. GT-proviral discordance was significantly larger than plasma-proviral discordance. GT or proviral mutations discordant from plasma led to clinically relevant resistance in 24% and 30%, respectively. Conclusions: We identified high resistance and high inter-compartmental resistance discordance in Indian women, which might lead to unrecognized resistance transmission and re-emergence compromising treatment outcomes, particularly relevant to countries like India, where sexual HIV transmission is predominant.

Indexed as

Drug Resistance, ViralAdolescentAdultAgedBloodFemaleGenitaliaGenotypeGenotyping TechniquesHIV-1HIV InfectionsHIV Reverse TranscriptaseHumansIndiaMiddle AgedTreatment FailureHIV Reverse Transcriptase

Identifiers

PMID29800305
PMCPMC6927885
OpenAlexW2804656780

What OpenQuestion holds

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Registered trials

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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.