Continuation of emtricitabine/lamivudine within combination antiretroviral therapy following detection of the M184V/I HIV‐1 resistance mutation
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Continuation of emtricitabine/lamivudine within combination antiretroviral therapy following detection of the M184V/I HIV‐1 resistance mutation

Ot Stirrup,D Asboe,A Pozniak,Ca Sabin,R Gilson,Ne Mackie,A Tostevin,T Hill,Dt Dunn,David Chadwick,Duncan Churchill,Duncan Clark,Simon Collins,Valerie Delpech,Samuel Douthwaite,Esther Fearnhill,Kholoud Porter,Christophe Fraser,Anna Maria Geretti,Rory Gunson,Antony Hale,Stéphane Hué,Linda Lazarus,Andrew Leigh‐Brown,Tamyo Mbisa,Chloe Orkin,Eleni Nastouli,Deenan Pillay,Andrew Phillips,Erasmus Smit,Kate Templeton,Peter Tilston,Erik Volz,Ian Williams,Hongyi Zhang,Keith Fairbrother,Justine Dawkins,Siobhan O’Shea,Jane Mullen,Alison Cox,Richard Tandy,Tracy Fawcett,Mark Hopkins,Clare Booth,Ana Garcia‐Diaz,Lynne Renwick,Matthias L. Schmid,Brendan Payne,Jonathan Hubb,Simon Dustan,Stuart Kirk,Amanda Bradley‐Stewart,Jonathan Ainsworth,Sris Allan,Jane Anderson,Ade Apoola,Ian Fairley,Ashini Fox,Mark Gompels,Phillip Hay,Rajesh Hembrom,Margaret Johnson,Sophie Jose,Stephen Kegg,Clifford Leen,Dushyant Mital,Mark Nelson,Hajra Okhai,Adrian Palfreeman,Ashley Price,Frank Post,Jillian Pritchard,Achim Schwenk,Anjum Tariq,Roy Trevelion,Andy Ustianowski,John Walsh,Nadine Looy,Janet Lynch,James Hand,Stuart Tilbury,Elaney Youssef,Richard Daly,Sundhiya Mandalia,Sajid Munshi,Ade Adefisan,Chris Taylor,Zachary Gleisner,Fowzia Ibrahim,Lucy Campbell,Kirsty Baillie,Sheila Miller,Chris Wood,Mike Youle,Nicky Mackie,Alan Winston,Jonathan Weber,Farhan Ramzan,Mark Carder,Andrew Kerr,David Wilks,Sheila Morris,Sue Allan,Adam Lewszuk,Victoria Ogunbiyi,Sue Mitchell,Christopher Hunt,Olanike Okolo,Benjamin Watts,Sarah Russell‐Sharpe,Olatunde Fagbayimu,Debra Brain,Liz Radford,Sarah Milgate,Shirley Cumming,Claire Atkinson,Annie Rose,Jeanette Smith,Cynthia Murphy,Ilise Gunder,Howard Gees,Gemma Squires,Laura Anderson,Serena Mansfield,Lee Tomlinson,Christine LeHegerat,Roberta Box,Tom Hatton,Doreen Herbert,Ian McVittie,Victoria Murtha,Laura Shewan,Zak Connan,Luke Gregory,Kathleen Holding,Victoria Chester,Trusha Mistry,Catherine Gatford,the UK HIV Drug Resistance Database and the UK Collaborative HIV Cohort;Ot Stirrup;D Asboe;A Pozniak;Ca Sabin;R Gilson;Ne Mackie;A Tostevin;T Hill;Dt Dunn;David Chadwick;Duncan Churchill;Duncan Clark;Simon Collins;Valerie Delpech;Samuel Douthwaite;Esther Fearnhill;Kholoud Porter;Christophe Fraser;Anna Maria Geretti;Rory Gunson;Antony Hale;Stéphane Hué;Linda Lazarus;Andrew Leigh‐Brown;Tamyo Mbisa;Chloe Orkin;Eleni Nastouli;Deenan Pillay;Andrew Phillips;Erasmus Smit;Kate Templeton;Peter Tilston;Erik Volz;Ian Williams;Hongyi Zhang;Keith Fairbrother;Justine Dawkins;Siobhan O’Shea;Jane Mullen;Alison Cox;Richard Tandy;Tracy Fawcett;Mark Hopkins;Clare Booth;Ana Garcia‐Diaz;Lynne Renwick;Matthias L. Schmid;Brendan Payne;Jonathan Hubb;Simon Dustan;Stuart Kirk;Amanda Bradley‐Stewart;Jonathan Ainsworth;Sris Allan;Jane Anderson;Ade Apoola;Ian Fairley;Ashini Fox;Mark Gompels;Phillip Hay;Rajesh Hembrom;Margaret Johnson;Sophie Jose;Stephen Kegg;Clifford Leen;Dushyant Mital;Mark Nelson;Hajra Okhai;Adrian Palfreeman;Ashley Price;Frank Post;Jillian Pritchard;Achim Schwenk;Anjum Tariq;Roy Trevelion;Andy Ustianowski;John Walsh;Nadine Looy;Janet Lynch;James Hand;Stuart Tilbury;Elaney Youssef;Richard Daly;Sundhiya Mandalia;Sajid Munshi;Ade Adefisan;Chris Taylor;Zachary Gleisner;Fowzia Ibrahim;Lucy Campbell;Kirsty Baillie;Sheila Miller;Chris Wood;Mike Youle;Nicky Mackie;Alan Winston;Jonathan Weber;Farhan Ramzan;Mark Carder;Andrew Kerr;David Wilks;Sheila Morris;Sue Allan;Adam Lewszuk;Victoria Ogunbiyi;Sue Mitchell;Christopher Hunt;Olanike Okolo;Benjamin Watts;Sarah Russell‐Sharpe;Olatunde Fagbayimu;Debra Brain;Liz Radford;Sarah Milgate;Shirley Cumming;Claire Atkinson;Annie Rose;Jeanette Smith;Cynthia Murphy;Ilise Gunder;Howard Gees;Gemma Squires;Laura Anderson;Serena Mansfield;Lee Tomlinson;Christine LeHegerat;Roberta Box;Tom Hatton;Doreen Herbert;Ian McVittie;Victoria Murtha;Laura Shewan;Zak Connan;Luke Gregory;Kathleen Holding;Victoria Chester;Trusha Mistry;Catherine Gatford;the UK HIV Drug Resistance Database and the UK Collaborative HIV Cohort;
HIV medicine 2020 Vol. 21 pp. 309-321
199
cohort2020hivcontinuation

Abstract

Objectives The aim of the study was to investigate whether lamivudine (3TC) or emtricitabine (FTC) use following detection of M184V/I is associated with better virological outcomes. Methods We identified people with viruses harbouring the M184V/I mutation in UK multicentre data sets who had treatment change/initiation within 1 year. We analysed outcomes of viral suppression (< 200 HIV‐1 RNA copies/mL) and appearance of new major drug resistance mutations (DRMs) using Cox and Poisson models, with stratification by new drug regimen (excluding 3TC/FTC) and Bayesian implementation, and estimated the effect of 3TC/FTC adjusted for individual and viral characteristics. Results We included 2597 people with the M184V/I resistance mutation, of whom 665 (25.6%) were on 3TC and 458 (17.6%) on FTC. We found a negative adjusted association between 3TC/FTC use and viral suppression [hazard ratio (HR) 0.84; 95% credibility interval (CrI) 0.71–0.98]. On subgroup analysis of individual drugs, there was no evidence of an association with viral suppression for 3TC (n = 184; HR 0.94; 95% CrI 0.73–1.15) or FTC (n = 454; HR 0.99; 95% CrI 0.80–1.19) amongst those on tenofovir‐containing regimens, but we estimated a reduced rate of viral suppression for people on 3TC amongst those without tenofovir use (n = 481; HR 0.71; 95% CrI 0.54–0.90). We found no association between 3TC/FTC and detection of any new DRM (overall HR 0.92; 95% CrI 0.64–1.18), but found inconclusive evidence of a lower incidence rate of new DRMs (overall incidence rate ratio 0.69; 95% CrI 0.34–1.11). Conclusions We did not find evidence that 3TC or FTC use is associated with an increase in viral suppression, but it may reduce the appearance of additional DRMs in people with M184V/I. 3TC was associated with reduced viral suppression amongst people on regimens without tenofovir.

Keywords

hiv emtricitabine lamivudine m184i m184v

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DOI:
10.1111/hiv.12829
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https://sciprofiles.com/publication/view/db4c060fe...

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