GHTM

Global Health and Tropical Medicine

  • GHTM
    • About GHTM
    • Governance
    • Impact
    • Members
      • Population health, policies and services
        • PPS PhD members
        • PPS non PhD members
      • TB, HIV and opportunistic diseases and pathogens
        • THOP PhD members
        • THOP non PhD members
      • Vector-borne diseases
        • VBD PhD members
        • VBD non PhD members
      • Individual Health Care
        • IHC PhD members
        • IHC non PhD members
      • Tech & Admin support
    • Scientific Advisory Board
  • Research
    • Cross-cutting issues
      • Global Pathogen Dispersion and Population Mobility
      • Drug Discovery and Drug Resistance
      • Diagnostics
      • Public Health Information
      • Fair Research Partnerships
    • Research Groups
      • PPS – Population health, policies and services
      • THOP – TB, HIV and opportunistic diseases and pathogens
      • VBD – Vector borne diseases
      • IHC – Individual health care
    • Research in numbers
      • 2023
      • 2022
      • 2021
      • 2020
      • 2019
      • 2018
      • 2017
    • Projects
      • Ongoing Projects
      • Completed Projects
  • Outreach
    • Events
    • News
    • Policy Support & Community Outreach
  • Publications
    • 2024
    • 2023
    • 2022
    • 2021
    • 2020
    • 2019
    • 2018
    • 2017
    • 2016
    • 2015
  • Capacity Building
    • Education
      • Master Theses
      • PhD Theses
    • International
  • Infrastructures
  • Networks & Partnerships
  • Reports
    • GHTM
    • Scientific Advisory Board
    • FCT
Home / Publications / The effect of primary drug resistance on CD4 cell decline and the viral load set-point in HIV-positive individuals before the start of antiretroviral therapy

The effect of primary drug resistance on CD4 cell decline and the viral load set-point in HIV-positive individuals before the start of antiretroviral therapy

  • Authors: Schultze A, Torti C, Cozzi-Lepri A, Vandamme AM, Zazzi M, Sambatakou H, De Luca A, Geretti AM, Sönnerborg A, Ruiz L, Monno L, Di Giambenedetto S, Gori A, Lapadula G
  • Publication Year: 2019
  • Journal: AIDS
  • Link: https://www.ncbi.nlm.nih.gov/pubmed/30325769
OBJECTIVE:

To evaluate the effect of primary resistance and selected polymorphic amino-acid substitutions in HIV reverse transcriptase and protease on the CD4 cell count and viral load set point before the start of antiretroviral treatment.

DESIGN:

Prospective cohort study.

METHODS:

A total of 6180 individuals with a resistance test prior to starting antiretroviral treatment accessing care in HIV clinics across Europe who had at least one viral load and one CD4 test available were included in the analysis. The impact of amino-acid substitutions variants on viral load and CD4 trends was investigated using linear mixed models. Clusters of mutations were studied using principal component analysis.

RESULTS:

Overall, the detection of any primary resistance was not associated with either the speed of CD4 cell decline or the viral load set point. However, transmitted nucleoside reverse transcriptase inhibitor and protease inhibitor resistance appeared to be weakly associated with lower viral load set points, as were the polymorphic G16E or Q92K protease mutations. There was some evidence suggesting that these effects varied according to HIV subtype, with the effects of transmitted nucleoside reverse transcriptase inhibitor and protease resistance being particularly marked among individuals with a subtype B virus. A cluster of five polymorphic protease substitutions at position 20, 13, 36, 69 and 89 was associated with less steep CD4 cell declines and lower viral load set points.

CONCLUSION:

Although we found little evidence for an association between primary resistance and CD4 speed of decline and viral load set point, the potential role of polymorphic protease (alone or in clusters) and their interplay with HIV subtype needs to be further evaluated.

Share this:

  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on X (Opens in new window) X
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to print (Opens in new window) Print

About GHTM

GHTM is a R&D Unit that brings together researchers with a track record in Tropical Medicine and International & Global Health. It aims at strengthening Portugal's role as a leading partner in the development and implementation of a global health research agenda. Our evidence-based interventions contribute to the promotion of equity in health and to improve the health of populations.

Contacts

Rua da Junqueira, 100
1349-008 Lisboa
Portugal

+351 213 652 600

  • E-mail
  • Facebook
  • LinkedIn
  • Twitter
  • YouTube

Map

  • Events
  • Research Groups
  • Cross-cutting issues
© Copyright 2025 IHMT-UNL All Rights Reserved.
  • Universidade Nova de Lisboa
  • Fundação para a Ciência e a Tecnologia

    UIDB/04413/2020
    UIDP/04413/2020

We use cookies to ensure that we give you the best experience on our website. If you continue to use this site we will assume that you are happy with it.Ok