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HIV-1 drug resistance testing is essential for heavily-treated patients switching from first- to second-line regimens in resource-limited settings: evidence from routine clinical practice in Cameroon.


ABSTRACT: BACKGROUND:With the phase-out of stavudine (d4T), change to first-line regimens with zidovudine (AZT) or tenofovir (TDF) in resource-limited settings (RLS) might increase risks of cross-resistance to nucleos(t) ide reverse transcriptase inhibitors (NRTI). This would restrict the scope of switching to the World Health Organisation (WHO)-recommended standard second-line combinations (SLC) without HIV drug resistance (HIVDR)-testing in routine clinical practice. METHODS:An observational study was conducted among 101 Cameroonian patients (55.4% male, median [IQR] age 34 [10-41] years) failing first-line antiretroviral therapy (ART) in 2016, and stratified into three groups according to NRTIs exposure: exposure to both thymidine analogues AZT "and" D4T (group-A, n =?55); exposure to both TDF and AZT "or" D4T (group-B, n =?22); exposure solely to D4T (group-C, n =?24). Protease-reverse transcriptase HIVDR was interpreted using the HIVdb penalty scores (?60: high-resistance; 20-59: intermediate-resistance;

PROVIDER: S-EPMC6419466 | BioStudies |

REPOSITORIES: biostudies

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