White, EM;
Tostevin, A;
Sabin, C;
Pillay, D;
Dunn, DT;
Smit, E;
Churchill, D;
... Booth, C; + view all
(2016)
No evidence that HIV-1 subtype C infection compromises the efficacy of tenofovir containing regimens: cohort study in the United Kingdom.
Journal of Infectious Diseases
, 214
(9)
pp. 1302-1308.
10.1093/infdis/jiw213.
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Abstract
Concern has been expressed that tenofovir-containing regimens may have reduced effectiveness in the treatment of HIV-1 subtype C infections due to a propensity for these viruses to develop a key tenofovir-associated resistance mutation. We evaluated whether subtype influenced rates of virological failure in a cohort of 8746 patients from the United Kingdom who received a standard tenofovir-containing first-line regimen and were followed for a median of 3.3 years. In unadjusted analyses, the rate of failure was approximately two-fold higher among patients with subtype C virus compared to subtype B (hazard ratio[HR]=1.85,95% CI 1.49-2.33,P<0.001). However, the increased risk was greatly attenuated in analyses adjusting for demographic and clinical factors (adjusted HR=1.15,95% CI 0.83-1.59,P=0.41). There were no differences between subtypes C and non-B/C in either univariate or multivariate analysis. These observations imply there is no intrinsic effect of viral subtype on the efficacy of tenofovir-containing regimens.
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