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Basic Characteristics of Mutations
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Mutation Site
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Y188C |
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Mutation Site Sentence
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In addition, the OLA did not detect resistance to NNRTI in one participant with V106M and Y188C, or resistance to 3TC in four participants with M184I, as these mutations were not interrogated by the OLA. |
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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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Y |
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Treatment
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NNRTIs |
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Location
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Kenyans |
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Literature Information
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PMID
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31956856
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Title
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Pre-treatment HIV-drug resistance associated with virologic outcome of first-line NNRTI-antiretroviral therapy: A cohort study in Kenya
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Author
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Beck IA,Levine M,McGrath CJ,Bii S,Milne RS,Kingoo JM,So I,Andersen N,Dross S,Coombs RW,Kiarie J,Chohan B,Sakr SR,Chung MH,Frenkel LM
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Journal
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EClinicalMedicine
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Journal Info
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2020 Jan 14;18:100239
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Abstract
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BACKGROUND: Pre-treatment HIV-drug-resistance (PDR) to WHO-recommended 1st-line non-nucleoside reverse transcriptase inhibitors (NNRTI)-based antiretroviral treatment (ART) is increasing in low-resource communities. We evaluated the risk of PDR on treatment failure if detected at single or multiple codons, at minority (2-9%) or higher (>/=10%) frequencies during efavirenz- vs. nevirapine-ART. METHODS: We conducted a pooled analysis across three cohorts of Kenyans initiating 1st-line NNRTI-ART between 2006 and 2014. Mutations K103N, Y181C, G190A, M184V and K65R were detected by an oligonucleotide ligation assay (OLA) and confirmed by Sanger and next-generation sequencing (NGS). PDR was defined as detection of any mutation by OLA when confirmed by NGS. Treatment failure, defined as plasma HIV RNA >/=400 copies/mL at month-12 of ART, was compared by PDR genotypes. FINDINGS: PDR was detected in 59/1231 (4.8%) participants. Compared to wild-type genotypes, PDR in participants prescribed nevirapine-ART was associated with increased treatment failure [PDR 69.2% (27/39) vs. wild-type 10.4% (70/674); p = 0.0001], whether detected as minority [66.7% (4/6)] or higher [69.7% (23/33)] frequencies in an individual's HIV quasispecies (p = 0.002 and p < 0.0001, respectively), or mutations at single [50.0% (12/24)] or multiple [100.0% (15/15)] codons (p < 0.0001). During efavirenz-ART, PDR was also associated with increased virologic failure [PDR 25.0% (5/20) vs. wild-type 5.0% (25/498); p = 0.005], but only if detected at multiple drug-resistant codons [50.0% (3/6); p = 0.003] or high frequencies PDR [33.3% (5/15); p = 0.001]. INTERPRETATION: The risk that PDR confers for treatment failure varies by number of mutant codons and their frequency in the quasispecies, with a lower risk for efavirenz- compared to nevirapine-based regimens. PDR detection and management could extend the effective use of efavirenz-ART in low-resource settings. FUNDING: NIH, PEPFAR.
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Sequence Data
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KF544089-KF544288; KJ395348-KJ395349; MH509760-MH509936; MK512771-MK513407
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