Rapid emergence of resistance to antiretroviral treatment after undisclosed prior exposure : a case report

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rossouw_rapid_2019.pdf(496.81 KB)
Date
2019
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Publisher
AOSIS Publishing
Abstract
Introduction: Patients who disengaged from care may present as therapy naïve for antiretroviral treatment (ART) initiation at a different site, without being recognised as being at an increased risk of rapid treatment failure and HIV drug resistance. Patient presentation: A 43-year-old woman, who gave no prior history of ART, was initiated on a standard first-line regimen of TDF, FTC and EFV. She had a poor response to treatment with evidence of treatment failure at 12 months. Management and outcome: HIV-1 drug resistance tests showed no pre-treatment HIVDR mutations, but revealed high-level drug resistance to all component drugs at 12 months. On investigation, viral load (VL) was recorded in 2012 and 2013, providing evidence of prior ART use. Conclusion: Linkage of patient therapy and laboratory information to unique patient identifiers may allow health-care workers to identify patients who previously received ART and disengaged from care. This will enable differentiated care when these patients reinitiate ART, which should involve expedited VL testing and more rapid transition to definitive second-line ART.
Description
CITATION: Rossouw, T. M., Van Dyk, G. & Van Zyl, G. 2019. Rapid emergence of resistance to antiretroviral treatment after undisclosed prior exposure : a case report. Southern African Journal of HIV Medicine, (20(1):a965, doi:10.4102/sajhivmed.v20i1.965.
The original publication is available at http://www.sajhivmed.org.za/
Keywords
HIV drug resistance, Drug resistance, Antiretroviral agents, HIV-infected persons
Citation
Rossouw, T. M., Van Dyk, G. & Van Zyl, G. 2019. Rapid emergence of resistance to antiretroviral treatment after undisclosed prior exposure : a case report. Southern African Journal of HIV Medicine, (20(1):a965, doi:10.4102/sajhivmed.v20i1.965
URI
http://hdl.handle.net/10019.1/109597
Collections
Research Articles (Medical Virology)