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Basic Characteristics of Mutations
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Mutation Site
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G11B |
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Mutation Site Sentence
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Figure 3 Panel (A) Drug resistance mutations to the different classes of ARVs found among the participants experiencing virological failure that were successfully sequenced (n = 183). Panel (B) Level of resistance to the different classes of ARVs among the participants experiencing virological failure that were successfully sequenced (n = 183). Mutation profiles and susceptibility predictions were determined using Stanford HIV Drug Resistance Database Version 8.8.0. Proportion of sequences with DRMs to the different classes of ARVs are divided into nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and integrase strand transfer inhibitors (INSTIs) (Panel (A)). Individual predicted susceptibility for each antiretroviral (ARV) was categorized according to high-level, intermediate-level, and low-level resistance, and susceptibility (Panel (B)). Abbreviations: ARV, antiretroviral therapy; NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor; INSTI, integrase strand transfer inhibitor; ABC, abacavir; AZT, azidothymidine (zidovudine); D4T, stavudine; FTC, emtricitabine; 3TC, lamivudine; TDF, tenofovir; DOR, doravirine; EFV, efavirenz; ETR, etravirine; NVP, nevirapine; RPV, rilpivirine; ATV, atazanavir; DRV, darunavir; LPV, lopinavir; TPV, tipranavir; BIC, bictegravir; CAB, cabotegravir; DTG, dolutegravir; EVG, elvitegravir; RAL, raltegravir. |
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Mutation Level
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Amino acid level |
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Mutation Type
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Nonsynonymous substitution |
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Gene/Protein/Region
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RT |
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Standardized Encoding Gene
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gag-pol:155348
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Genotype/Subtype
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HIV-1 |
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Viral Reference
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-
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Functional Impact and Mechanisms
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Disease
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HIV Infections
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Immune
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- |
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Target Gene
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-
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Clinical and Epidemiological Correlations
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Clinical Information
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Y |
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Treatment
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NNRTI |
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Location
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Mozambique |
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Literature Information
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PMID
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39861009
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Title
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HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique
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Author
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Ismael N,Hussein C,Magul C,Inguane H,Couto A,Nhangave A,Muteerwa A,Bonou M,Ramos A,Young PW,Chilundo S,Machekano R,Greenberg L,da Silva J,Bhatt N
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Journal
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Pathogens (Basel, Switzerland)
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Journal Info
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2025 Jan 9;14(1):48
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Abstract
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Real-world data on HIV drug resistance (HIVDR) after transitioning to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) are limited. We assessed HIVDR rates and patterns in clients with virological failure (VF) after switching from an NNRTI-based regimen to TLD. A cross-sectional study was conducted in Gaza, Mozambique (August 2021-February 2022), including adults on first-line ART for >/=12 months who transitioned to TLD and had unsuppressed viral load (VL) >/= 1000 copies/mL six months post-transition. After three adherence counseling sessions, participants with VF underwent genotyping for drug resistance mutations (DRMs) using the Stanford HIVdb Program. Of 717 participants (median age 39.2 years, 70.7% female), 217 (30.2%) had VF, 193 (88.9%) underwent genotyping, with 183 (94.8%) successfully genotyped. Intermediate-high dolutegravir (DTG) resistance was found in 19.6% (36/183). Unsuppressed VL before DTG transition was independently associated with VF (aOR: 2.14). Resistance patterns included 33.3% (12/36; 95% CI: 14.6-46.3) to all three TLD drugs, 55.6% (20/36; 95% CI: 39.3-71.9) to DTG and 3TC, and 11% (4/36; 95% CI: 0.8-21.3) to DTG only. Major drug resistance mutations to DTG included G118R (9.3%), R263K (6.6%), and Q148H/R/K (4.4%). This study highlights the need to consider virologic status before transitioning PLHIV to TLD and suggests that adherence counseling may not prevent resistance in those with unknown or prior VF.
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Sequence Data
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-
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