000			nab a22 7a 4500
999			_c16345 _d16345
003			PC16344
005			20210702062700.0
008			210412b xxu||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_91016 _aDelgado Vázquez, Rafael _eMicrobiología y Parasitología
100			_91026 _aPulido Ortega, Federico _eUnidad VIH
245	0	0	_aImproved prediction of salvage antiretroviral therapy outcomes using ultrasensitive HIV-1 drug resistance testing. _h[artículo]
260			_bClinical infectious diseases : an official publication of the Infectious Diseases Society of America, _c2014
300			_a59(4):578-88.
500			_aFormato Vancouver: Pou C, Noguera-Julian M, Pérez-Álvarez S, García F, Delgado R, Dalmau D et al. Improved prediction of salvage antiretroviral therapy outcomes using ultrasensitive HIV-1 drug resistance testing. Clin Infect Dis. 2014 Aug 15;59(4):578-88.
501			_aPMID: 24879788
504			_aContiene 33 referencias
520			_aBackground: The clinical relevance of ultrasensitive human immunodeficiency virus type 1 (HIV-1) genotypic resistance testing in antiretroviral treatment (ART)-experienced individuals remains unknown. Methods: This was a retrospective, multicentre, cohort study in ART-experienced, HIV-1-infected adults who initiated salvage ART including, at least 1 ritonavir-boosted protease inhibitor, raltegravir or etravirine. Presalvage ART Sanger and 454 sequencing of plasma HIV-1 were used to generate separate genotypic sensitivity scores (GSS) using the HIVdb, ANRS, and REGA algorithms. Virological failure (VF) was defined as 2 consecutive HIV-1 RNA levels ≥200 copies/mL at least 12 weeks after salvage ART initiation, whereas subjects remained on the same ART. The ability of Sanger and 454-GSS to predict VF was assessed by receiver operating characteristic (ROC) curves and survival analyses. Results: The study included 132 evaluable subjects; 28 (21%) developed VF. Using HIVdb, 454 predicted VF better than Sanger sequencing in the ROC curve analysis (area under the curve: 0.69 vs 0.60, Delong test P = .029). Time to VF was shorter for subjects with 454-GSS < 3 vs 454-GSS ≥ 3 (Log-rank P = .003) but not significantly different between Sanger-GSS < 3 and ≥3. Factors independently associated with increased risk of VF in multivariate Cox regression were a 454-GSS < 3 (HR = 4.6, 95 CI, [1.5, 14.0], P = .007), and the number of previous antiretrovirals received (HR = 1.2 per additional drug, 95 CI, [1.1, 1.3], P = .001). Equivalent findings were obtained with the ANRS and REGA algorithms. Conclusions: Ultrasensitive HIV-1 genotyping improves GSS-based predictions of virological outcomes of salvage ART relative to Sanger sequencing. This may improve the clinical management of ART-experienced subjects living with HIV-1.
710			_9625 _aInstituto de Investigación imas12
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/1/pc16345.pdf _ySolicitar documento
942			_2ddc _cART _n0