High rate of HIV resuppression after viral failure on first-line antiretroviral therapy in the absence of switch to second-line therapy

Ravindra K Gupta; Ruth L Goodall; Michael Ranopa; Cissy Kityo; Paula Munderi; Fred Lyagoba; Lincoln Mugarura; Charles F Gilks; Pontiano Kaleebu; Deenan Pillay; DART Virology Group and Trial Team

doi:10.1093/cid/cit933

High rate of HIV resuppression after viral failure on first-line antiretroviral therapy in the absence of switch to second-line therapy

Clin Infect Dis. 2014 Apr;58(7):1023-6. doi: 10.1093/cid/cit933. Epub 2013 Dec 18.

Authors

Ravindra K Gupta¹, Ruth L Goodall, Michael Ranopa, Cissy Kityo, Paula Munderi, Fred Lyagoba, Lincoln Mugarura, Charles F Gilks, Pontiano Kaleebu, Deenan Pillay; DART Virology Group and Trial Team

Collaborators

DART Virology Group and Trial Team:
H Grosskurth, P Munderi, G Kabuye, D Nsibambi, R Kasirye, E Zalwango, M Nakazibwe, B Kikaire, G Nassuna, R Massa, K Fadhiru, M Namyalo, A Zalwango, L Generous, P Khauka, N Rutikarayo, W Nakahima, A Mugisha, J Todd, J Levin, S Muyingo, A Ruberantwari, P Kaleebu, D Yirrell, N Ndembi, F Lyagoba, P Hughes, M Aber, A Medina Lara, S Foster, J Amurwon, P Mugyenyi, C Kityo, F Ssali, D Tumukunde, T Otim, J Kabanda, H Musana, J Akao, H Kyomugisha, A Byamukama, J Sabiiti, J Komugyena, P Wavamunno, S Mukiibi, A Drasiku, R Byaruhanga, O Labeja, P Katundu, S Tugume, P Awio, A Namazzi, T G Bakeinyaga, H Katabira, D Abaine, J Tukamushaba, W Anywar, W Ojiambo, E Angweng, S Murungi, W Haguma, S Atwiine, J Kigozi, A Latif, J Hakim, V Robertson, A Reid, E Chidziva, R Bulaya-Tembo, G Musoro, F Taziwa, C Chimbetete, L Chakonza, A Mawora, C Muvirimi, G Tinago, P Svovanapasis, M Simango, O Chirema, J Machingura, S Mutsai, M Phiri, T Bafana, M Chirara, L Muchabaiwa, M Muzambi, E Katabira, A Ronald, A Kambungu, F Lutwama, A Nanfuka, J Walusimbi, E Nabankema, R Nalumenya, T Namuli, R Kulume, I Namata, L Nyachwo, A Florence, A Kusiima, E Lubwama, R Nairuba, F Oketta, E Buluma, R Waita, H Ojiambo, F Sadik, J Wanyama, P Nabongo, R Ochai, D Muhweezi, C Gilks, K Boocock, C Puddephatt, D Winogron, J Bohannon, J Darbyshire, M D Gibb, A Burke, D Bray, A Babiker, S A Walker, H Wilkes, M Rauchenberger, S Sheehan, L Peto, K Taylor, M Spyer, A Ferrier, B Naidoo, D Dunn, R Goodall, R Nanfuka, C Mufuka-Kapuya, P Kaleebu, D Pillay, P Awio, M Chirara, D Dunn, C Gilks, R Goodall, A Kapaata, M Katuramur, F Lyagoba, R Magala, B Magambo, K Mataruka, A McCormick, L Mugarura, T Musunga, M Nabankkema, J Nkalubo, P Nkurunziza, C Parry, V Robertson, M Spyer, D Yirrell, A Medina Lara, S Foster, J Amurwon, B Nyanzi Wakholi, J Kigozi, L Muchabaiwa, M Muzambi, I Weller, A Babiker, S Bahendeka, M Bassett, A Chogo Wapakhabulo, J Darbyshire, B Gazzard, C Gilks, J Hakim, A Latif, C Mapuchere, O Mugurungi, P Mugyenyi, C Burke, S Jones, C Newland, S Rahim, J Rooney, M Smith, W Snowden, J-M Steens, A Breckenridge, A McLaren, C Hill, J Matenga, A Pozniak, D Serwadda, T Peto, A Palfreeman, M Borok, E Katabira

Affiliation

¹ Department of Infection.

Abstract

In a randomized comparison of nevirapine or abacavir with zidovudine plus lamivudine, routine viral load monitoring was not performed, yet 27% of individuals with viral failure at week 48 experienced resuppression by week 96 without switching. This supports World Health Organization recommendations that suspected viral failure should trigger adherence counseling and repeat measurement before a treatment switch is considered.

Keywords: Africa; HIV; failure; resistance; viral resuppression.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Anti-HIV Agents / administration & dosage
Anti-HIV Agents / therapeutic use*
Dideoxynucleosides / administration & dosage
Dideoxynucleosides / therapeutic use
Drug Combinations
Humans
Lamivudine / administration & dosage
Lamivudine / therapeutic use*
Nevirapine / administration & dosage
Nevirapine / therapeutic use
Viral Load / drug effects
Viremia / drug therapy
Zidovudine / administration & dosage
Zidovudine / therapeutic use*

Substances

Anti-HIV Agents
Dideoxynucleosides
Drug Combinations
lamivudine, zidovudine drug combination
Lamivudine
Zidovudine
Nevirapine
abacavir

Abstract

Publication types

MeSH terms

Substances

Grants and funding