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dc.contributor.authorCevik, Muge
dc.contributor.authorOrkin, Chloe
dc.contributor.authorSax, Paul E
dc.date.accessioned2020-08-03T11:30:08Z
dc.date.available2020-08-03T11:30:08Z
dc.date.issued2020-06
dc.identifier269436080
dc.identifier68350e0d-966b-4654-bcd2-84b8b3632e1d
dc.identifier32587877
dc.identifier000565181000035
dc.identifier85092064339
dc.identifier.citationCevik , M , Orkin , C & Sax , P E 2020 , ' Emergent resistance to dolutegravir among INSTI-naïve patients on first-line or second-line antiretroviral therapy : a review of published cases ' , Open Forum Infectious Diseases , vol. 7 , no. 6 , ofaa202 . https://doi.org/10.1093/ofid/ofaa202en
dc.identifier.issn2328-8957
dc.identifier.otherPubMedCentral: PMC7304932
dc.identifier.urihttps://hdl.handle.net/10023/20395
dc.description.abstractNone of the licensing studies of dolutegravir (DTG) reported any treatment-emergent resistance among DTG-treated individuals, though virological failure in treatment-naïve and treatment-experienced, integrase strand transfer inhibitor (INSTI)-naïve individuals has been reported in clinical practice. While the spectrum of dolutegravir-selected mutations and their effects on clinical outcome have been described, the clinical characteristics of these rare but important virological failure cases are often overlooked. In this perspective piece, we focus on key clinical aspects of emergent resistance to DTG among treatment-naïve and treatment-experienced INSTI-naïve patients, with an aim to inform clinical decision-making. Poor adherence and HIV disease factors contribute to emergent drug resistance, even in regimens with high resistance barriers. Patients with severe immunosuppression or poor adherence are under-represented in licensing studies, and these patients may be at higher risk of treatment failure with DTG resistance, which requires close clinical and laboratory follow-up.
dc.format.extent4
dc.format.extent162213
dc.language.isoeng
dc.relation.ispartofOpen Forum Infectious Diseasesen
dc.subjectDolutegraviren
dc.subjectHIVen
dc.subjectTreatment failureen
dc.subjectTreatment-naïveen
dc.subjectResistanceen
dc.subjectQR180 Immunologyen
dc.subjectQR355 Virologyen
dc.subjectRM Therapeutics. Pharmacologyen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.subject.lccQR180en
dc.subject.lccQR355en
dc.subject.lccRMen
dc.titleEmergent resistance to dolutegravir among INSTI-naïve patients on first-line or second-line antiretroviral therapy : a review of published casesen
dc.typeJournal itemen
dc.contributor.institutionUniversity of St Andrews. Infection and Global Health Divisionen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.identifier.doi10.1093/ofid/ofaa202
dc.description.statusPeer revieweden


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