Efficacy of Efavirenz-Based Regimen in Antiretroviral-Naive Patients with HIV-1 V179D/E Mutations in Shanghai, China

Wang, Zhenyan1; Zhang, Min2; Wang, Jiangrong1; Liu, Li1; Chen, Jun1; Zhang, Renfang1; Tang, Yang1; Shen, Yinzhong1; Qi, Tangkai1; Song, Wei1; Sun, Jianjun1; Xu, Shuibao1; Yang, Junyang1; Lu, Hongzhou3

2022-11-01

10.1007/s40121-022-00723-8

Infectious Diseases and Therapy   Impact Factor & Quartile

2193-8229

2193-6382

Introduction This study aimed to evaluate the prevalence of HIV-1 mutation V179D/E and the effect of V179D/E on the virological response to first-line efavirenz-based regimens among antiretroviral treatment (ART)-naive patients. Methods An ambispective cohort study was conducted. All ART-naive patients who underwent baseline genotypic resistance testing between January 2019 and November 2021 were included in the analysis of the prevalence of the V179D/E mutation. Then, patients with identified V179D/E received the efavirenz-based regimen or the protease inhibitor (PI)/integrase strand transfer inhibitor (INSTI)-based regimen. The virological and immunological outcomes at week 48 were compared between the two groups. Results HIV-1 mutation V179D/E was identified in 252 out of 2568 ART-naive patients, with a prevalence of 9.8% in Shanghai, China. A total of 206 participants were included in the efficacy analysis. Forty-six patients with altered ART regimens or incomplete follow-up data were excluded from the analysis. The baseline characteristics were comparable between the efavirenz group (n = 109) and the PI/INSTI group (n = 97). At week 48, a total of 96 participants (88.1%) in the efavirenz group and 92 participants (94.8%) in the PI/INSTI group had a viral load lower than 50 copies/mL (chi-square test, p = 0.086). In both groups, a lower proportion of participants achieved virological suppression among participants with a baseline viral load of at least 100,000 copies/mL compared with those with lower than 100,000 copies/mL (66.7% vs. 96.1% in the efavirenz group, p < 0.001; 87.1% vs. 98.4% in the PI/INSTI group, p = 0.039). The median increase from baseline in the CD4 count at week 48 was significantly greater in the PI/INSTI group (192 cells/mu L) than in the efavirenz group (154 cells/mu L) (p = 0.029). Conclusion There is a high prevalence of V179D/E in ART-naive patients with HIV-1 in Shanghai, China. The first-line efavirenz-based regimen may be not suitable for patients with HIV-1 mutation V179D/E, especially for those with a baseline viral load of at least 100,000 copies/mL. The study was registered at the Chinese Clinical Trial Registry (ChiCTR2000034787).

HIV Mutation V179D V179E Efavirenz Antiretroviral Protease inhibitor Integrase strand transfer inhibitor

SCI

English

Non-SUSTech

Shanghai Municipal Health Commission[201940225] ; Shanghai major projects on infectious diseases[shslczdzk01102] ; Three-Year Action Plan for Strengthening Public Health System in Shanghai[GWV-10.1-XK02]

Infectious Diseases

Infectious Diseases

WOS:000889411300005

SPRINGER LONDON LTD

Web of Science

1.Fudan Univ, Shanghai Publ Hlth Clin Ctr, Dept Infect & Immun, 2901 Caolang Rd, Shanghai 201508, Peoples R China
2.Shanghai Publ Hlth Clin Ctr, Clin Lab, Shanghai, Peoples R China
3.Southern Univ Sci & Technol, State Key Discipline Infect Dis, Natl Clin Res Ctr Infect Dis,Hosp 2, Shenzhen Key Lab Pathogen & Immun,Peoples Hosp Sh, Shenzhen 518112, Guangdong, Peoples R China

Wang, Zhenyan,Zhang, Min,Wang, Jiangrong,et al. Efficacy of Efavirenz-Based Regimen in Antiretroviral-Naive Patients with HIV-1 V179D/E Mutations in Shanghai, China[J]. Infectious Diseases and Therapy,2022.

Wang, Zhenyan.,Zhang, Min.,Wang, Jiangrong.,Liu, Li.,Chen, Jun.,...&Lu, Hongzhou.(2022).Efficacy of Efavirenz-Based Regimen in Antiretroviral-Naive Patients with HIV-1 V179D/E Mutations in Shanghai, China.Infectious Diseases and Therapy.

Wang, Zhenyan,et al."Efficacy of Efavirenz-Based Regimen in Antiretroviral-Naive Patients with HIV-1 V179D/E Mutations in Shanghai, China".Infectious Diseases and Therapy (2022).