Imperial College London
Portrait Picture

ProfessorAlanWinston

Faculty of Medicine, Department of Infectious Disease

Professor of Genito-Urinary Medicine
 
 
 
//

Contact

 

+44 (0)20 3312 1603a.winston

 
 
//

Location

 

Winston Churchill WingSt Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Stirrup:2020:10.1111/hiv.12829,
author = {Stirrup, OT and Asboe, D and Pozniak, A and Sabin, CA and Gilson, R and Mackie, NE and Tostevin, A and Hill, T and Dunn, DT and UK, HIV Drug Resistance Database and the UK Collaborative HIV Cohort},
doi = {10.1111/hiv.12829},
journal = {HIV Medicine},
pages = {309--321},
title = {Continuation of emtricitabine/lamivudine within combination antiretroviral therapy following detection of the M184V/I HIV-1 resistance mutation},
url = {http://dx.doi.org/10.1111/hiv.12829},
volume = {21},
year = {2020}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - 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.
AU  - Stirrup,OT
AU  - Asboe,D
AU  - Pozniak,A
AU  - Sabin,CA
AU  - Gilson,R
AU  - Mackie,NE
AU  - Tostevin,A
AU  - Hill,T
AU  - Dunn,DT
AU  - UK,HIV Drug Resistance Database and the UK Collaborative HIV Cohort
DO  - 10.1111/hiv.12829
EP  - 321
PY  - 2020///
SN  - 1464-2662
SP  - 309
TI  - Continuation of emtricitabine/lamivudine within combination antiretroviral therapy following detection of the M184V/I HIV-1 resistance mutation
T2  - HIV Medicine
UR  - http://dx.doi.org/10.1111/hiv.12829
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31927793
UR  - http://hdl.handle.net/10044/1/80767
VL  - 21
ER  -
Download