Evidence map›Paper›PMID 32434561›Full record

ArticleAIDS research and therapy2020

Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi.

F Neuhann, A de Forest, E Heger, A Nhlema, C Scheller, R Kaiser, H M Steffen, H Tweya, G Fätkenheuer, S Phiri

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in AIDS research and therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
0.2field-weighted citation impact, top 35% 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

9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
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  6. Review
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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

10 authors at 6 institutions in 3 countries.

F NeuhannHeidelberg Institute for Global Health, University Hospital of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany. florian.neuhann@uni-heidelberg.de.ORCID 0000-0001-5944-1597
A de ForestHeidelberg Institute for Global Health, University Hospital of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
E HegerInstitute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
A NhlemaLighthouse Clinic, Lilongwe, Malawi.
C SchellerInstitute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany.
R KaiserInstitute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
H M SteffenClinic for Gastroenterology and Hepatology, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
H TweyaLighthouse Clinic, Lilongwe, Malawi.
G FätkenheuerDepartment of Internal Medicine I, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
S PhiriLighthouse Clinic, Lilongwe, Malawi.
Heidelberg University · DELighthouse Trust · MWUniversity Hospital Cologne · DEUniversity of Cologne · DEUniversity of North Carolina at Chapel Hill · USUniversity of Würzburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPre-treatment drug resistance (PDR) among antiretroviral drug-naïve people living with HIV (PLHIV) represents an important indicator for the risk of treatment failure and the spread of drug resistant HIV variants. We assessed the prevalence of PDR and treatment outcomes among adults living with HIV-1 in Lilongwe, Malawi.

methodsWe selected 200 participants at random from the Lighthouse Tenofovir Cohort Study (LighTen). Serum samples were drawn prior to treatment initiation in 2014 and 2015, frozen, and later analyzed for the presence of HIV-1 drug resistance mutations. Amplicons were sequenced and interpreted by Stanford HIVdb interpretation algorithm 8.4. We assessed treatment outcomes by evaluating clinical outcome and viral suppression at the end of the follow-up period in October 2019.

resultsPDR testing was successful in 197 of 200 samples. The overall NNRTI- PDR prevalence was 13.7% (27/197). The prevalence of intermediate or high level NNRTI- PDR was 11.2% (22/197). The most common mutation was K103N (5.6%, 11/197), followed by Y181C (3.6%, 7/197). In one case, we detected an NRTI resistance mutation (M184V), in combination with multiple NNRTI resistance mutations. All HIV-1 isolates analyzed were of subtype C. Of the 27 patients with NNRTI- PDR, 9 were still alive, on ART, and virally suppressed at the end of follow-up.

conclusionThe prevalence of NNRTI- PDR was above the critical level of 10% suggested by the Global Action Plan on HIV Drug Resistance. The distribution of drug resistance mutations was similar to that seen in previous studies from the region, and further supports the introduction of integrase inhibitors in first-line treatment in Malawi. Furthermore, our findings underline the need for continued PDR surveillance and pharmacovigilance in Sub-Saharan Africa.

Indexed as

AdultAnti-HIV AgentsCohort StudiesDrug Administration ScheduleDrug Resistance, ViralFemaleGenotypeHIV-1HIV InfectionsHumansMalawiMaleMiddle AgedMutationPrevalenceTreatment FailureAnti-HIV AgentsDrug resistance mutationsHIVMalawiNon-nucleoside reverse transcriptasePretreatment resistance

Identifiers

PMID32434561
PMCPMC7240935
OpenAlexW3027238354

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LicenceCC BY
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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.