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Basic Characteristics of Mutations
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Mutation Site
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M184V |
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Mutation Site Sentence
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Her genotype resistance assay showed the M184V mutation indicating resistance to emtricitabine, and she was virally suppressed three months after initiation of tenofovir, emtricitabine and efavirenz. |
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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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- |
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Treatment
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emtricitabine (FTC) |
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Location
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South Africa |
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Literature Information
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PMID
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33247553
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Title
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Incentives conditioned on tenofovir levels to support PrEP adherence among young South African women: a randomized trial
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Author
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Celum CL,Gill K,Morton JF,Stein G,Myers L,Thomas KK,McConnell M,van der Straten A,Baeten JM,Duyver M,Mendel E,Naidoo K,Dallimore J,Wiesner L,Bekker LG
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Journal
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Journal of the International AIDS Society
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Journal Info
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2020 Nov;23(11):e25636
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Abstract
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INTRODUCTION: HIV incidence remains high among African adolescent girls and young women (AGYW), who would benefit from pre-exposure prophylaxis (PrEP). Strategies to increase PrEP adherence and persistence need to be evaluated in African AGY, including incentives conditional on high adherence. METHODS: The 3Ps for Prevention Study was a 12-month prospective cohort of 200 women ages 16 to 25 initiating PrEP in South Africa from 2017 to 2018. Participants received retrospective feedback about drug levels at Months 1, 2 and 3; half was randomized to receive a 200 Rand shopping voucher ($13 US) at Months 2, 3 and 4, conditioned on high intracellular tenofovir diphosphate (TFV-DP) levels in dried blood spots (>/=500 fmol/punch at Month 1, >/=700 fmol/punch at Months 2 and 3). The primary analysis was intention-to-treat, comparing the proportion with high PrEP adherence (>/=700 fmol/punch) at Month 3 by randomized group, based on 100% efficacy among men who have sex with men. RESULTS: Median age of the 200 women was 19 years (interquartile range [IQR] 17, 21); 86% had a primary sexual partner. At Month 3, the mean TFV-DP level was 822 fmol/punch (SD 522) in the incentive group and 689 fmol/punch (SD 546) in the control group (p = 0.11). Forty-five (56%) of 85 women in the incentive group and 35 (41%) of 85 women in the control group had TFV-DP levels >/=700 fmol/punch (RR 1.35; 95% CI 0.98, 1.86; p = 0.067), which declined to 8% and 5% in the incentive and control groups at Month 12 (no significant difference by arm). 44% refilled PrEP without gaps, 14% had a gap of >/=3 weeks in coverage subsequently restarted PrEP and 54% accepted at the final dispensing visit at Month 9. No new HIV infections were observed after PrEP initiation. CONCLUSIONS: Among South African AGYW initiating PrEP, drug levels indicated high PrEP adherence in almost half of women at Month 3, with a non-statistically significant higher proportion with high adherence among those in the incentive group. Over half persisted with the 12-month PrEP programme although high adherence declined after Month 3. Strategies to support PrEP adherence and persistence and longer-acting PrEP formulations are needed.
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Sequence Data
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-
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