ArticleHIV medicine2021
Virological failure and HIV drug resistance among adults living with HIV on second-line antiretroviral therapy in the Asia-Pacific.
Article in HIV medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- Article
- Prevalence and factors associated with drug resistance mutations among HIV - 1 patients failing to achieve virological suppression on second line treatment in Tanzania.BMC infectious diseases · 2026Article
- 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
- Article
- Non-compliance to antiretroviral therapy readjustments following complications in HIV-positive patients in South Africa.Journal of public health in Africa · 2025Article
- Predictors of antiretroviral treatment failure to the first line therapy: a cross-sectional study among Iranian HIV-positive adults.BMC infectious diseases · 2024Article
- HIV protease resistance mutations in patients receiving second-line antiretroviral therapy in Libreville, Gabon.BMC infectious diseases · 2024Article
- Mortality Risk Factors Among People Living with HIV Receiving Second-line Antiretroviral Therapy in Rural China.Current HIV research · 2024Article
- HIV Drug Resistance Mutations and Subtype Profiles among Pregnant Women of Ho Chi Minh City, South Vietnam.Viruses · 2023Article
- Causes of HIV Treatment Interruption during the Last 20 Years: A Multi-Cohort Real-Life Study.Viruses · 2023Article
- Identification of 3-Oxindole Derivatives as Small Molecule HIV-1 Inhibitors Targeting Tat-Mediated Viral Transcription.Molecules (Basel, Switzerland) · 2022Article
- Effects of Chinese Medicine on the Survival of AIDS Patients Administered Second-Line ART in Rural Areas of China: A Retrospective Cohort Study Based on Real-World Data.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program.Journal of the International Association of Providers of AIDS CareArticle
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Authors and funding
16 authors at 13 institutions in 11 countries.
Funding
Abstract
objectivesTo assess second-line antiretroviral therapy (ART) virological failure and HIV drug resistance-associated mutations (RAMs), in support of third-line regimen planning in Asia.
methodsAdults > 18 years of age on second-line ART for ≥ 6 months were eligible. Cross-sectional data on HIV viral load (VL) and genotypic resistance testing were collected or testing was conducted between July 2015 and May 2017 at 12 Asia-Pacific sites. Virological failure (VF) was defined as VL > 1000 copies/mL with a second VL > 1000 copies/mL within 3-6 months. FASTA files were submitted to Stanford University HIV Drug Resistance Database and RAMs were compared against the IAS-USA 2019 mutations list. VF risk factors were analysed using logistic regression.
resultsOf 1378 patients, 74% were male and 70% acquired HIV through heterosexual exposure. At second-line switch, median [interquartile range (IQR)] age was 37 (32-42) years and median (IQR) CD4 count was 103 (43.5-229.5) cells/µL; 93% received regimens with boosted protease inhibitors (PIs). Median duration on second line was 3 years. Among 101 patients (7%) with VF, CD4 count > 200 cells/µL at switch [odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.17-0.77 vs. CD4 ≤ 50) and HIV exposure through male-male sex (OR = 0.32, 95% CI: 0.17-0.64 vs. heterosexual) or injecting drug use (OR = 0.24, 95% CI: 0.12-0.49) were associated with reduced VF. Of 41 (41%) patients with resistance data, 80% had at least one RAM to nonnucleoside reverse transcriptase inhibitors (NNRTIs), 63% to NRTIs, and 35% to PIs. Of those with PI RAMs, 71% had two or more.
conclusionsThere were low proportions with VF and significant RAMs in our cohort, reflecting the durability of current second-line regimens.
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