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HIV drug resistance in a cohort of HIV-infected MSM in the United States.

Publication ,  Journal Article
Fogel, JM; Sivay, MV; Cummings, V; Wilson, EA; Hart, S; Gamble, T; Laeyendecker, O; Fernandez, RE; Del Rio, C; Batey, DS; Mayer, KH; Beyrer, C ...
Published in: AIDS
January 1, 2020

OBJECTIVE: To analyze HIV drug resistance among MSM recruited for participation in the HPTN 078 study, which evaluated methods for achieving and maintaining viral suppression in HIV-infected MSM. METHODS: Individuals were recruited at four study sites in the United States (Atlanta, Georgia; Baltimore, Maryland; Birmingham, Alabama; and Boston, Massachusetts; 2016-2017). HIV genotyping was performed using samples collected at study screening or enrollment. HIV drug resistance was evaluated using the Stanford v8.7 algorithm. A multiassay algorithm was used to identify individuals with recent HIV infection. Clustering of HIV sequences was evaluated using phylogenetic methods. RESULTS: High-level HIV drug resistance was detected in 44 (31%) of 142 individuals (Atlanta: 21%, Baltimore: 29%, Birmingham: 53%, Boston: 26%); 12% had multiclass resistance, 16% had resistance to tenofovir or emtricitabine, and 8% had resistance to integrase strand transfer inhibitors (INSTIs); 3% had intermediate-level resistance to second-generation INSTIs. In a multivariate model, self-report of ever having been on antiretroviral therapy (ART) was associated with resistance (P = 0.005). One of six recently infected individuals had drug resistance. Phylogenetic analysis identified five clusters of study sequences; two clusters had shared resistance mutations. CONCLUSION: High prevalence of drug resistance was observed among MSM. Some had multiclass resistance, resistance to drugs used for preexposure prophylaxis (PrEP), and INSTI resistance. These findings highlight the need for improved HIV care in this high-risk population, identification of alternative regimens for PrEP, and inclusion of integrase resistance testing when selecting ART regimens for MSM in the United States.

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Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

January 1, 2020

Volume

34

Issue

1

Start / End Page

91 / 101

Location

England

Related Subject Headings

  • Virology
  • Viral Load
  • United States
  • Tenofovir
  • Sexual and Gender Minorities
  • Pre-Exposure Prophylaxis
  • Phylogeny
  • Male
  • Humans
  • Homosexuality, Male
 

Citation

APA
Chicago
ICMJE
MLA
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Fogel, J. M., Sivay, M. V., Cummings, V., Wilson, E. A., Hart, S., Gamble, T., … Eshleman, S. H. (2020). HIV drug resistance in a cohort of HIV-infected MSM in the United States. AIDS, 34(1), 91–101. https://doi.org/10.1097/QAD.0000000000002394
Fogel, Jessica M., Mariya V. Sivay, Vanessa Cummings, Ethan A. Wilson, Stephen Hart, Theresa Gamble, Oliver Laeyendecker, et al. “HIV drug resistance in a cohort of HIV-infected MSM in the United States.AIDS 34, no. 1 (January 1, 2020): 91–101. https://doi.org/10.1097/QAD.0000000000002394.
Fogel JM, Sivay MV, Cummings V, Wilson EA, Hart S, Gamble T, et al. HIV drug resistance in a cohort of HIV-infected MSM in the United States. AIDS. 2020 Jan 1;34(1):91–101.
Fogel, Jessica M., et al. “HIV drug resistance in a cohort of HIV-infected MSM in the United States.AIDS, vol. 34, no. 1, Jan. 2020, pp. 91–101. Pubmed, doi:10.1097/QAD.0000000000002394.
Fogel JM, Sivay MV, Cummings V, Wilson EA, Hart S, Gamble T, Laeyendecker O, Fernandez RE, Del Rio C, Batey DS, Mayer KH, Farley JE, McKinstry L, Hughes JP, Remien RH, Beyrer C, Eshleman SH. HIV drug resistance in a cohort of HIV-infected MSM in the United States. AIDS. 2020 Jan 1;34(1):91–101.

Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

January 1, 2020

Volume

34

Issue

1

Start / End Page

91 / 101

Location

England

Related Subject Headings

  • Virology
  • Viral Load
  • United States
  • Tenofovir
  • Sexual and Gender Minorities
  • Pre-Exposure Prophylaxis
  • Phylogeny
  • Male
  • Humans
  • Homosexuality, Male