SynthesisThe Journal of infectious diseases2021
Clinical Impact of Pretreatment Human Immunodeficiency Virus Drug Resistance in People Initiating Nonnucleoside Reverse Transcriptase Inhibitor-Containing Antiretroviral Therapy: A Systematic Review and Meta-analysis.
Synthesis in The Journal of infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
46 citing papers in PubMed, 4 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Prevalence and predictors of virological failure among the people living with HIV on antiretroviral treatment in East Africa: evidence from a systematic review with meta-analysis and meta-regression of published studies from 2016 to 2023.HIV research & clinical practice · 2025Pooled it
- Pooled it
- Pooled it
- Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review.AIDS research and therapy · 2023Pooled it
- Trial
- Effect of Non-nucleoside Resistance-Associated Mutations on the Effectiveness of Long-Acting Cabotegravir + Rilpivirine Therapy: Insights From the Real-World RELATIVITY Cohort.Open forum infectious diseases · 2026Article
- Extensive diversity and impact of drug-resistant HIV-1 variants in individuals with prior virologic failure.PLoS pathogens · 2026Article
- Association between infant post-natal prophylaxis regimens and pretreatment HIV drug resistance in infected infants.Frontiers in epidemiology · 2026Article
- A Robust Ensemble Machine Learning Approach for Inhibitor Discovery: Case Study of HIV-1 NNRTI and Validation Using MD Simulation.Chemistry, an Asian journal · 2026Article
- Investigation of the activity of phosphothioate and phosphothioate-LNA-modified oligonucleotides against HIV-1.Frontiers in medicine · 2026Article
- Analysis of HIV-1 subtypes and drug resistance mutations in people who inject drugs in Aizawl and nearby districts of Mizoram, India.Virulence · 2025Article
- Epidemic dynamics and clinical characteristics of HIV-1 CRF07_BC_N and CRF07_BC_O in Shanghai, 2017-2023.Virulence · 2025Article
- Pre-treatment and acquired HIV drug resistance in Hunan: a cross-sectional analysis of a growing challenge.BMC infectious diseases · 2025Article
- The association between HIV drug resistance testing, viral suppression and mortality in Ontario: a retrospective cohort study.HIV medicine · 2025Article
- HIV-1 Drug Resistance Trends in the Era of Modern Antiretrovirals: 2018-2024.Open forum infectious diseases · 2025Article
- Spatiotemporal patterns and influencing factors of genotypic resistance testing utilization among people living with HIV: A 10-year retrospective analysis at a tertiary care hospital in Beijing, China (2014-2023).Biosafety and health · 2025Article
- The Hallmarks of Ageing in Human Immunodeficiency Virus Infection and the Impact of Antiretroviral Therapy on Telomeres: A Molecular Perspective.Current issues in molecular biology · 2025Review
- Lenacapavir disrupts HIV-1 core integrity while stabilizing the capsid lattice.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- The Prevalence of Pretreatment Drug Resistance and Transmission Networks Among Newly Diagnosed HIV-1-Infected Individuals in Nanning, Guangxi, China.Pathogens (Basel, Switzerland) · 2025Article
- Prevalence and transmission of HIV-1 drug resistance mutations among patients with treatment failure and newly diagnosed people in Liangshan Prefecture, China, in 2021-2023.Frontiers in public health · 2025Article
Corrections and comments
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Authors and funding
15 authors at 9 institutions in 8 countries.
Funding
Abstract
backgroundIncreased access to antiretroviral therapy (ART) has resulted in rising levels of pretreatment human immunodeficiency virus drug resistance (PDR). This is the first systematic review and meta-analysis to assess the impact of PDR on treatment outcomes among people initiating nonnucleoside reverse transcriptase inhibitor (NNRTI)-based ART, including the combination of efavirenz (EFV), tenofovir (TDF), and lamivudine or emtricitabine (XTC).
methodsWe systematically reviewed studies and conference proceedings comparing treatment outcomes in populations initiating NNRTI-based ART with and without PDR. We conducted subgroup analyses by regimen: (1) NNRTIs + 2 nucleoside reverse transcriptase inhibitors (NRTIs), (2) EFV + 2 NRTIs, or (3) EFV/TDF/XTC; by population (children vs adults); and by definition of resistance (PDR vs NNRTI PDR).
resultsAmong 6197 studies screened, 32 were analyzed (31 441 patients). We found that individuals with PDR initiating NNRTIs across all the subgroups had increased risk of virological failure compared to those without PDR. Risk of acquisition of new resistance mutations and ART switch was also higher in people with PDR.
conclusionsThis review shows poorer treatment outcomes in the presence of PDR, supporting the World Health Organization's recommendation to avoid using NNRTIs in countries where levels of PDR are high.
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Registered trials
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.