Antiretroviral Resistance among HIV-Infected Persons Who Have Died in British Columbia, in the Era of Modern Antiretroviral Therapy
Background. The prevalence of antiretroviral resistance among persons enrolled in the centralized HIV/AIDS Drug Treatment Program in British Columbia, Canada, who had died between July 1997 and December 2001, was investigated, to determine the degree to which antiretroviral resistance contributed to...
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| Veröffentlicht in: | The Journal of infectious diseases 2004-07, Vol.190 (2), p.285-292 |
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| creator | Recsky, Magdalena A. Brumme, Zabrina L. Chan, Keith J. Wynhoven, Brian Yip, Benita Dong, Winnie W. Y. Heath, Katherine V. Montaner, Julio S. G. Levy, Adrian R. Hogg, Robert S. Harrigan, P. Richard |
| description | Background. The prevalence of antiretroviral resistance among persons enrolled in the centralized HIV/AIDS Drug Treatment Program in British Columbia, Canada, who had died between July 1997 and December 2001, was investigated, to determine the degree to which antiretroviral resistance contributed to mortality. Methods. During this period, 637 deaths had occurred. The last plasma sample obtained during therapy was genotyped retrospectively for treated individuals who had died of a nonaccidental cause. Samples with plasma human immunodeficiency virus (HIV) loads |
| doi_str_mv | 10.1086/422007 |
| format | Article |
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Y. ; Heath, Katherine V. ; Montaner, Julio S. G. ; Levy, Adrian R. ; Hogg, Robert S. ; Harrigan, P. Richard</creator><creatorcontrib>Recsky, Magdalena A. ; Brumme, Zabrina L. ; Chan, Keith J. ; Wynhoven, Brian ; Yip, Benita ; Dong, Winnie W. Y. ; Heath, Katherine V. ; Montaner, Julio S. G. ; Levy, Adrian R. ; Hogg, Robert S. ; Harrigan, P. Richard</creatorcontrib><description>Background. The prevalence of antiretroviral resistance among persons enrolled in the centralized HIV/AIDS Drug Treatment Program in British Columbia, Canada, who had died between July 1997 and December 2001, was investigated, to determine the degree to which antiretroviral resistance contributed to mortality. Methods. During this period, 637 deaths had occurred. The last plasma sample obtained during therapy was genotyped retrospectively for treated individuals who had died of a nonaccidental cause. Samples with plasma human immunodeficiency virus (HIV) loads <500 copies/mL were not genotyped. Drug resistance among 1220 living HIV-infected persons who had experienced virologic therapy failure during the study period also was examined. Results. Of 554 individuals who had died of nonaccidental causes, 58 (10.4%) were antiretroviral naive, and99 (17.9%) had very brief exposure to antiretroviral therapy (median, 2 months). The majority of isolates from the remaining 397 individuals harbored either no major resistance mutations or represented samples with plasma HIV suppression of <500 copies/mL. Resistance to ⩾1, ⩾2, or 3 drug classes was observed in 76%, 42%, and 11% of individuals, respectively, in the group of 1220 living individuals experiencing virologic therapy failure, compared with only 44%, 23%, and 5% of individuals, respectively, who had died (P <.001). Conclusion. Only a relatively low prevalence of multidrug resistance was observed in this cohort, indicating that the exhaustion of treatment options because of drug resistance was not a significant contributor to mortality.</description><identifier>ISSN: 0022-1899</identifier><identifier>EISSN: 1537-6613</identifier><identifier>DOI: 10.1086/422007</identifier><identifier>PMID: 15216463</identifier><identifier>CODEN: JIDIAQ</identifier><language>eng</language><publisher>Chicago, IL: The University Chicago Press</publisher><subject>Adult ; Amino Acid Substitution ; Anti-HIV Agents - pharmacology ; Anti-HIV Agents - therapeutic use ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; British Columbia ; Drug Resistance, Multiple, Viral - genetics ; Drug Resistance, Viral - genetics ; Female ; Fundamental and applied biological sciences. Psychology ; Genotype ; HIV - drug effects ; HIV - genetics ; HIV - isolation & purification ; HIV Infections - drug therapy ; HIV Infections - mortality ; HIV Infections - virology ; HIV Protease - genetics ; HIV Protease Inhibitors - pharmacology ; HIV Protease Inhibitors - therapeutic use ; HIV Reverse Transcriptase - genetics ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infectious diseases ; Male ; Medical sciences ; Microbiology ; Middle Aged ; Mutation ; Prevalence ; Reverse Transcriptase Inhibitors - pharmacology ; Reverse Transcriptase Inhibitors - therapeutic use ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral Load</subject><ispartof>The Journal of infectious diseases, 2004-07, Vol.190 (2), p.285-292</ispartof><rights>2004 by the Infectious Diseases Society of America 2004</rights><rights>2004 INIST-CNRS</rights><rights>Copyright University of Chicago Press Jul 15, 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-44d0dbd59d9bd6f12e36630456e1ea281508d6b1391a1b011d4d5d59576a9a5b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16020609$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15216463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Recsky, Magdalena A.</creatorcontrib><creatorcontrib>Brumme, Zabrina L.</creatorcontrib><creatorcontrib>Chan, Keith J.</creatorcontrib><creatorcontrib>Wynhoven, Brian</creatorcontrib><creatorcontrib>Yip, Benita</creatorcontrib><creatorcontrib>Dong, Winnie W. Y.</creatorcontrib><creatorcontrib>Heath, Katherine V.</creatorcontrib><creatorcontrib>Montaner, Julio S. G.</creatorcontrib><creatorcontrib>Levy, Adrian R.</creatorcontrib><creatorcontrib>Hogg, Robert S.</creatorcontrib><creatorcontrib>Harrigan, P. Richard</creatorcontrib><title>Antiretroviral Resistance among HIV-Infected Persons Who Have Died in British Columbia, in the Era of Modern Antiretroviral Therapy</title><title>The Journal of infectious diseases</title><addtitle>The Journal of Infectious Diseases</addtitle><addtitle>The Journal of Infectious Diseases</addtitle><description>Background. The prevalence of antiretroviral resistance among persons enrolled in the centralized HIV/AIDS Drug Treatment Program in British Columbia, Canada, who had died between July 1997 and December 2001, was investigated, to determine the degree to which antiretroviral resistance contributed to mortality. Methods. During this period, 637 deaths had occurred. The last plasma sample obtained during therapy was genotyped retrospectively for treated individuals who had died of a nonaccidental cause. Samples with plasma human immunodeficiency virus (HIV) loads <500 copies/mL were not genotyped. Drug resistance among 1220 living HIV-infected persons who had experienced virologic therapy failure during the study period also was examined. Results. Of 554 individuals who had died of nonaccidental causes, 58 (10.4%) were antiretroviral naive, and99 (17.9%) had very brief exposure to antiretroviral therapy (median, 2 months). The majority of isolates from the remaining 397 individuals harbored either no major resistance mutations or represented samples with plasma HIV suppression of <500 copies/mL. Resistance to ⩾1, ⩾2, or 3 drug classes was observed in 76%, 42%, and 11% of individuals, respectively, in the group of 1220 living individuals experiencing virologic therapy failure, compared with only 44%, 23%, and 5% of individuals, respectively, who had died (P <.001). Conclusion. Only a relatively low prevalence of multidrug resistance was observed in this cohort, indicating that the exhaustion of treatment options because of drug resistance was not a significant contributor to mortality.</description><subject>Adult</subject><subject>Amino Acid Substitution</subject><subject>Anti-HIV Agents - pharmacology</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>British Columbia</subject><subject>Drug Resistance, Multiple, Viral - genetics</subject><subject>Drug Resistance, Viral - genetics</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Genotype</subject><subject>HIV - drug effects</subject><subject>HIV - genetics</subject><subject>HIV - isolation & purification</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - mortality</subject><subject>HIV Infections - virology</subject><subject>HIV Protease - genetics</subject><subject>HIV Protease Inhibitors - pharmacology</subject><subject>HIV Protease Inhibitors - therapeutic use</subject><subject>HIV Reverse Transcriptase - genetics</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Prevalence</subject><subject>Reverse Transcriptase Inhibitors - pharmacology</subject><subject>Reverse Transcriptase Inhibitors - therapeutic use</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Viral Load</subject><issn>0022-1899</issn><issn>1537-6613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0dFqFDEUBuAgil2rPoJEQa8cPUkmmcll3VZ3paJoreJNyEzOuGlnJ2syU-y1L27KLi0UxKvA4eM_nPyEPGbwikGtXpecA1R3yIxJURVKMXGXzAA4L1it9R55kNIZAJRCVffJHpOcqVKJGflzMIw-4hjDhY-2p58x-TTaoUVq12H4SRfL02I5dNiO6OgnjCkMiX5bBbqwF0gPfZ76gb6JfvRpReehn9aNty-vhuMK6VG0NHT0Q3AYB3pr2ckKo91cPiT3OtsnfLR798nXt0cn80Vx_PHdcn5wXLSl1GNRlg5c46R2unGqYxyFUgJKqZCh5TWTUDvVMKGZZQ0w5konM5eVstrKRuyTF9vcTQy_JkyjWfvUYt_bAcOUjFKq1FrJ_0JWVSChggyf3YJnYYpDPsJwLjTUIn_ydVobQ0oRO7OJfm3jpWFgrsoz2_IyfLJLm5o1uhu2ayuD5ztgU2v7LuaefLpxCjgo0Nk93bowbf69rNiaXDf-vlY2nhtViUqaxfcfRh2efqlr8d5I8Re_cbhI</recordid><startdate>20040715</startdate><enddate>20040715</enddate><creator>Recsky, Magdalena A.</creator><creator>Brumme, Zabrina L.</creator><creator>Chan, Keith J.</creator><creator>Wynhoven, Brian</creator><creator>Yip, Benita</creator><creator>Dong, Winnie W. Y.</creator><creator>Heath, Katherine V.</creator><creator>Montaner, Julio S. G.</creator><creator>Levy, Adrian R.</creator><creator>Hogg, Robert S.</creator><creator>Harrigan, P. Richard</creator><general>The University Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20040715</creationdate><title>Antiretroviral Resistance among HIV-Infected Persons Who Have Died in British Columbia, in the Era of Modern Antiretroviral Therapy</title><author>Recsky, Magdalena A. ; Brumme, Zabrina L. ; Chan, Keith J. ; Wynhoven, Brian ; Yip, Benita ; Dong, Winnie W. Y. ; Heath, Katherine V. ; Montaner, Julio S. 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Psychology</topic><topic>Genotype</topic><topic>HIV - drug effects</topic><topic>HIV - genetics</topic><topic>HIV - isolation & purification</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - mortality</topic><topic>HIV Infections - virology</topic><topic>HIV Protease - genetics</topic><topic>HIV Protease Inhibitors - pharmacology</topic><topic>HIV Protease Inhibitors - therapeutic use</topic><topic>HIV Reverse Transcriptase - genetics</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Prevalence</topic><topic>Reverse Transcriptase Inhibitors - pharmacology</topic><topic>Reverse Transcriptase Inhibitors - therapeutic use</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Viral Load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Recsky, Magdalena A.</creatorcontrib><creatorcontrib>Brumme, Zabrina L.</creatorcontrib><creatorcontrib>Chan, Keith J.</creatorcontrib><creatorcontrib>Wynhoven, Brian</creatorcontrib><creatorcontrib>Yip, Benita</creatorcontrib><creatorcontrib>Dong, Winnie W. Y.</creatorcontrib><creatorcontrib>Heath, Katherine V.</creatorcontrib><creatorcontrib>Montaner, Julio S. G.</creatorcontrib><creatorcontrib>Levy, Adrian R.</creatorcontrib><creatorcontrib>Hogg, Robert S.</creatorcontrib><creatorcontrib>Harrigan, P. Richard</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Recsky, Magdalena A.</au><au>Brumme, Zabrina L.</au><au>Chan, Keith J.</au><au>Wynhoven, Brian</au><au>Yip, Benita</au><au>Dong, Winnie W. Y.</au><au>Heath, Katherine V.</au><au>Montaner, Julio S. G.</au><au>Levy, Adrian R.</au><au>Hogg, Robert S.</au><au>Harrigan, P. Richard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antiretroviral Resistance among HIV-Infected Persons Who Have Died in British Columbia, in the Era of Modern Antiretroviral Therapy</atitle><jtitle>The Journal of infectious diseases</jtitle><stitle>The Journal of Infectious Diseases</stitle><addtitle>The Journal of Infectious Diseases</addtitle><date>2004-07-15</date><risdate>2004</risdate><volume>190</volume><issue>2</issue><spage>285</spage><epage>292</epage><pages>285-292</pages><issn>0022-1899</issn><eissn>1537-6613</eissn><coden>JIDIAQ</coden><abstract>Background. The prevalence of antiretroviral resistance among persons enrolled in the centralized HIV/AIDS Drug Treatment Program in British Columbia, Canada, who had died between July 1997 and December 2001, was investigated, to determine the degree to which antiretroviral resistance contributed to mortality. Methods. During this period, 637 deaths had occurred. The last plasma sample obtained during therapy was genotyped retrospectively for treated individuals who had died of a nonaccidental cause. Samples with plasma human immunodeficiency virus (HIV) loads <500 copies/mL were not genotyped. Drug resistance among 1220 living HIV-infected persons who had experienced virologic therapy failure during the study period also was examined. Results. Of 554 individuals who had died of nonaccidental causes, 58 (10.4%) were antiretroviral naive, and99 (17.9%) had very brief exposure to antiretroviral therapy (median, 2 months). The majority of isolates from the remaining 397 individuals harbored either no major resistance mutations or represented samples with plasma HIV suppression of <500 copies/mL. Resistance to ⩾1, ⩾2, or 3 drug classes was observed in 76%, 42%, and 11% of individuals, respectively, in the group of 1220 living individuals experiencing virologic therapy failure, compared with only 44%, 23%, and 5% of individuals, respectively, who had died (P <.001). Conclusion. Only a relatively low prevalence of multidrug resistance was observed in this cohort, indicating that the exhaustion of treatment options because of drug resistance was not a significant contributor to mortality.</abstract><cop>Chicago, IL</cop><pub>The University Chicago Press</pub><pmid>15216463</pmid><doi>10.1086/422007</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The Journal of infectious diseases, 2004-07, Vol.190 (2), p.285-292 |
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| source | Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Amino Acid Substitution Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Antiretroviral Therapy, Highly Active Biological and medical sciences British Columbia Drug Resistance, Multiple, Viral - genetics Drug Resistance, Viral - genetics Female Fundamental and applied biological sciences. Psychology Genotype HIV - drug effects HIV - genetics HIV - isolation & purification HIV Infections - drug therapy HIV Infections - mortality HIV Infections - virology HIV Protease - genetics HIV Protease Inhibitors - pharmacology HIV Protease Inhibitors - therapeutic use HIV Reverse Transcriptase - genetics Human immunodeficiency virus Human viral diseases Humans Infectious diseases Male Medical sciences Microbiology Middle Aged Mutation Prevalence Reverse Transcriptase Inhibitors - pharmacology Reverse Transcriptase Inhibitors - therapeutic use Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral Load |
| title | Antiretroviral Resistance among HIV-Infected Persons Who Have Died in British Columbia, in the Era of Modern Antiretroviral Therapy |
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