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Basic Characteristics of Mutations
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Mutation Site
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K219E |
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Mutation Site Sentence
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Table 2.Frequency of antiretroviral therapy (ART) resistance mutations among participants with viral load ≥ 1000 copies/mL (n = 105) |
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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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- |
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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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- |
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Treatment
|
NRTIs |
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Location
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Uganda |
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Literature Information
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PMID
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31432614
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Title
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Lack of effectiveness of adherence counselling in reversing virological failure among patients on long-term antiretroviral therapy in rural Uganda
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Author
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Birungi J,Cui Z,Okoboi S,Kapaata A,Munderi P,Mukajjanga C,Nanfuka M,Nyonyintono MS,Kim J,Zhu J,Kaleebu P,Moore DM
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Journal
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HIV medicine
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Journal Info
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2020 Jan;21(1):21-29
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Abstract
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OBJECTIVES: The current World Health Organization and Uganda Ministry of Health HIV treatment guidelines recommend that asymptomatic patients who have a viral load (VL) >/= 1000 HIV-1 RNA copies/mL should receive adherence counselling and repeat VL testing before switching to second-line therapy. We evaluated the effectiveness of this strategy in a large HIV treatment programme of The AIDS Support Organisation Jinja in Jinja, Uganda. METHODS: We measured the HIV VL at enrolment, and for participants with VL >/= 1000 copies/mL we informed them of their result, offered enhanced adherence counselling and repeated the VL measurement after 3 months. All blood samples with VL >/= 1000 copies/mL were sequenced in the polymerase (pol) region, a 1257-bp fragment spanning the protease and reverse transcriptase genes. RESULTS: One thousand and ninety-one participants were enrolled in the study; 74.7% were female and the median age was 44 years [interquartile range (IQR) 39-50 years]. The median time on antiretroviral therapy (ART) at enrolment was 6.75 years (IQR 5.3-7.6 years) and the median CD4 cell count was 494 cells/muL (IQR 351-691 cells/muL). A total of 113 participants (10.4%) had VLs >/= 1000 copies/mL and were informed of the VL result and its implications and given adherence counselling. Of these 113 participants, 102 completed 3 months of follow-up and 93 (91%) still had VLs >/= 1000 copies/mL. We successfully genotyped HIV for 105 patients (93%) and found that 103 (98%) had at least one mutation: eight (7.6%) had only one mutation, 94 (89.5%) had two mutations and one sample (1%) had three mutations. CONCLUSIONS: In this study, enhanced adherence counselling was not effective in reversing virologically defined treatment failure for patients on long-term ART who had not previously had a VL test.
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Sequence Data
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-
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