Imperial College London
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ProfessorChristopheFraser

Faculty of Medicine, School of Public Health

Visiting Professor
 
 
 
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Contact

 

c.fraser Website

 
 
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Location

 

G28Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Geretti:2019:jac/dky468,
author = {Geretti, AM and White, E and Orkin, C and Tostevin, A and Tilston, P and Chadwick, D and Leen, C and Sabin, C and Dunn, DT and Asboe, D and Asboe, D and Pozniak, A and Cane, P and Chadwick, D and Churchill, D and Clark, D and Collins, S and Delpech, V and Douthwaite, S and Dunn, D and Fearnhill, E and Porter, K and Tostevin, A and Stirrup, O and Fraser, C and Gunson, R and Hale, A and Hue, S and Lazarus, L and Leigh-Brown, A and Mbisa, T and Mackie, N and Orkin, C and Nastouli, E and Pillay, D and Phillips, A and Sabin, C and Smit, E and Templeton, K and Tilston, P and Volz, E and Williams, I and Zhang, H and Dawkins, J and O'Shea, S and Mullen, J and Smit, E and Mbisa, T and Cox, A and Tandy, R and Fawcett, T and Hopkins, M and Tilston, P and Booth, C and Garcia-Diaz, A and Renwick, L and Schmid, ML and Payne, B and Chadwick, D and Hubb, J and Dustan, S and Kirk, S and Gunson, R and Bradley-Stewart, A and Ainsworth, J and Allan, S and Anderson, J and Babiker, A and Chadwick, D and Chu},
doi = {jac/dky468},
journal = {Journal of Antimicrobial Chemotherapy},
pages = {746--753},
title = {Virological outcomes of boosted protease inhibitor-based first-line ART in subjects harbouring thymidine analogue-associated mutations as the sole form of transmitted drug resistance},
url = {http://dx.doi.org/10.1093/jac/dky468},
volume = {74},
year = {2019}
}
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TY  - JOUR
AB  - ObjectivesIn subjects with transmitted thymidine analogue mutations (TAMs), boosted PIs (PI/b) are often chosen to overcome possible resistance to the NRTI backbone. However, data to guide treatment selection are limited. Our aim was to obtain firmer guidance for clinical practice using real-world cohort data.MethodsWe analysed 1710 subjects who started a PI/b in combination with tenofovir or abacavir plus emtricitabine or lamivudine, and compared their virological outcomes with those of 4889 patients who started an NNRTI (predominantly efavirenz), according to the presence of ≥1 TAM as the sole form of transmitted drug resistance.ResultsParticipants with ≥1 TAM comprised predominantly MSM (213 of 269, 79.2%), subjects of white ethnicity (206 of 269, 76.6%) and HIV-1 subtype B infections (234 of 269, 87.0%). Most (203 of 269, 75.5%) had singleton TAMs, commonly a revertant of T215Y or T215F (112 of 269, 41.6%). Over a median of 2.5 years of follow-up, 834 of 6599 (12.6%) subjects experienced viraemia (HIV-1 RNA >50 copies/mL). The adjusted HR for viraemia was 2.17 with PI/b versus NNRTI-based therapy (95% CI 1.88–2.51; P < 0.001). Other independent predictors of viraemia included injecting drug use, black ethnicity, higher viral load and lower CD4 cell count at baseline, and receiving abacavir instead of tenofovir. Resistance showed no overall impact (adjusted HR 0.77 with ≥1 TAM versus no resistance; 95% CI 0.54–1.10; P = 0.15).ConclusionsIn this cohort, patients harbouring ≥1 TAM as the sole form of transmitted drug resistance gained no apparent virological advantage from starting first-line ART with a PI/b.
AU  - Geretti,AM
AU  - White,E
AU  - Orkin,C
AU  - Tostevin,A
AU  - Tilston,P
AU  - Chadwick,D
AU  - Leen,C
AU  - Sabin,C
AU  - Dunn,DT
AU  - Asboe,D
AU  - Asboe,D
AU  - Pozniak,A
AU  - Cane,P
AU  - Chadwick,D
AU  - Churchill,D
AU  - Clark,D
AU  - Collins,S
AU  - Delpech,V
AU  - Douthwaite,S
AU  - Dunn,D
AU  - Fearnhill,E
AU  - Porter,K
AU  - Tostevin,A
AU  - Stirrup,O
AU  - Fraser,C
AU  - Gunson,R
AU  - Hale,A
AU  - Hue,S
AU  - Lazarus,L
AU  - Leigh-Brown,A
AU  - Mbisa,T
AU  - Mackie,N
AU  - Orkin,C
AU  - Nastouli,E
AU  - Pillay,D
AU  - Phillips,A
AU  - Sabin,C
AU  - Smit,E
AU  - Templeton,K
AU  - Tilston,P
AU  - Volz,E
AU  - Williams,I
AU  - Zhang,H
AU  - Dawkins,J
AU  - O'Shea,S
AU  - Mullen,J
AU  - Smit,E
AU  - Mbisa,T
AU  - Cox,A
AU  - Tandy,R
AU  - Fawcett,T
AU  - Hopkins,M
AU  - Tilston,P
AU  - Booth,C
AU  - Garcia-Diaz,A
AU  - Renwick,L
AU  - Schmid,ML
AU  - Payne,B
AU  - Chadwick,D
AU  - Hubb,J
AU  - Dustan,S
AU  - Kirk,S
AU  - Gunson,R
AU  - Bradley-Stewart,A
AU  - Ainsworth,J
AU  - Allan,S
AU  - Anderson,J
AU  - Babiker,A
AU  - Chadwick,D
AU  - Churchill,D
AU  - Delpech,V
AU  - Dunn,D
AU  - Gazzard,B
AU  - Gilson,R
AU  - Gompels,M
AU  - Hay,P
AU  - Hill,T
AU  - Johnson,M
AU  - Jose,S
AU  - Kegg,S
AU  - Leen,C
AU  - Martin,F
AU  - Mital,D
AU  - Nelson,M
AU  - Orkin,C
AU  - Palfreeman,A
AU  - Phillips,A
AU  - Pillay,D
AU  - Post,F
AU  - Pritchard,J
AU  - Sabin,CA
AU  - Schwenk,A
AU  - Tariq,A
AU  - Trevelion,R
AU  - Ustianowski,A
AU  - Walsh,J
AU  - Hill,T
AU  - Jose,S
AU  - Phillips,A
AU  - Sabin,CA
AU  - Thornton,A
AU  - Huntington,S
AU  - Dunn,D
AU  - Glabay,A
AU  - Shidfar,S
AU  - Orkin,C
AU  - Lynch,J
AU  - Hand,J
AU  - de,Souza C
AU  - Churchill,D
AU  - Perry,N
AU  - Tilbury,S
AU  - Youssef,E
AU  - Churchill,D
AU  - Gazzard,B
AU  - Nelson,M
AU  - Mabika,T
AU  - Asboe,D
AU  - Mandalia,S
AU  - Anderson,J
AU  - Munshi,S
AU  - Post,F
AU  - Adefisan,A
AU  - Taylor,C
AU  - Gleisner,Z
AU  - Ibrahim,F
AU  - Campbell,L
AU  - Chadwick,D
AU  - Baillie,K
AU  - Gilson,R
AU  - Brima,N
AU  - Williams,I
AU  - Ainsworth,J
AU  - Schwenk,A
AU  - Miller,S
AU  - Wood,C
AU  - Johnson,M
AU  - Youle,M
AU  - Lampe,F
AU  - Smith,C
AU  - Tsintas,R
AU  - Chaloner,C
AU  - Hutchinson,S
AU  - Sabin,CA
AU  - Phillips,A
AU  - Hill,T
AU  - Jose,S
AU  - Huntington,S
AU  - Thornton,A
AU  - Walsh,J
AU  - Mackie,N
AU  - Winston,A
AU  - Weber,J
AU  - Ramzan,F
AU  - Carder,M
AU  - Leen,C
AU  - Wilson,A
AU  - Morris,S
AU  - Gompels,M
AU  - Allan,S
AU  - Palfreeman,A
AU  - Lewszuk,A
AU  - Kegg,S
AU  - Faleye,A
AU  - Ogunbiyi,V
AU  - Mitchell,S
AU  - Hay,P
AU  - Kemble,C
AU  - Martin,F
AU  - Russell-Sharpe,S
AU  - Gravely,J
AU  - Allan,S
AU  - Harte,A
AU  - Tariq,A
AU  - Spencer,H
AU  - Jones,R
AU  - Pritchard,J
AU  - Cumming,S
AU  - Atkinson,C
AU  - Mital,D
AU  - Edgell,V
AU  - Allen,J
AU  - Ustianowski,A
AU  - Murphy,C
AU  - Gunder,I
AU  - Delpech,V
AU  - Trevelion,R
DO  - jac/dky468
EP  - 753
PY  - 2019///
SN  - 0305-7453
SP  - 746
TI  - Virological outcomes of boosted protease inhibitor-based first-line ART in subjects harbouring thymidine analogue-associated mutations as the sole form of transmitted drug resistance
T2  - Journal of Antimicrobial Chemotherapy
UR  - http://dx.doi.org/10.1093/jac/dky468
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000462835800030&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://academic.oup.com/jac/article/74/3/746/5245309
UR  - http://hdl.handle.net/10044/1/80740
VL  - 74
ER  -
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