Publicação

Management of HIV-2 resistance to antiretroviral therapy in a HIV-1/HIV-2/HBV co-infected patient

Ver documento

Detalhes bibliográficos
Resumo:Background: The current standard of care is to start antiretroviral therapy in all patients diagnosed with HIV-1, as for HIV-2 current DHHS guideline suggests ART for HIV-2 as soon as diagnosis is established, although this practice is not universal, for instance, in Portugal there are specific criteria to start treatment. Case presentation: We present a case of a man, chronically infected with HIV-1, HIV-2 and hepatitis B virus who developed resistance to HIV-2 while maintaining HIV-1 under control. 6 years after starting antiretroviral therapy he had his first virologic failure. We performed HIV-2 resistance tests that revealed high-grade resistance to all nucleoside reverse-transcriptase inhibitors except tenofovir and to all protease inhibitors except darunavir. After a decade of permanent poor adherence to therapy he developed resistance to both tenofovir and darunavir. We put together a new regiment with tenofovir alafenamide + emtricitabine + dolutegravir + maraviroc and nowadays he is with undetectable HIV-1 and HIV-2 viral loads. Conclusions: This shows the importance of having access to HIV-2 viral load determination and HIV-2 resistance testing.
Autores principais:Cardoso, Margarida
Outros Autores:Vasconcelos, Joana; Baptista, Teresa; Diogo, Isabel; Gonçalves, Fátima; Mansinho, Kamal; Gomes, Perpétua
Assunto:HIV-2 HIV-1 Resistance Mutation Coinfection Antiretroviral therapy
Ano:2021
País:Portugal
Tipo de documento:contribuição para revista
Tipo de acesso:acesso aberto
Instituição associada:Egas Moniz - Cooperativa de Ensino Superior, CRL
Idioma:inglês
Origem:Egas Moniz - Cooperativa de Ensino Superior, CRL
Descrição
Resumo:Background: The current standard of care is to start antiretroviral therapy in all patients diagnosed with HIV-1, as for HIV-2 current DHHS guideline suggests ART for HIV-2 as soon as diagnosis is established, although this practice is not universal, for instance, in Portugal there are specific criteria to start treatment. Case presentation: We present a case of a man, chronically infected with HIV-1, HIV-2 and hepatitis B virus who developed resistance to HIV-2 while maintaining HIV-1 under control. 6 years after starting antiretroviral therapy he had his first virologic failure. We performed HIV-2 resistance tests that revealed high-grade resistance to all nucleoside reverse-transcriptase inhibitors except tenofovir and to all protease inhibitors except darunavir. After a decade of permanent poor adherence to therapy he developed resistance to both tenofovir and darunavir. We put together a new regiment with tenofovir alafenamide + emtricitabine + dolutegravir + maraviroc and nowadays he is with undetectable HIV-1 and HIV-2 viral loads. Conclusions: This shows the importance of having access to HIV-2 viral load determination and HIV-2 resistance testing.