Sustained HIV Viral Suppression with Dolutegravir, Tenofovir, and Emtricitabine as Initial Therapy Despite High-Level Transmitted Multiclass Resistance

• Main Authors: Nagami, E.H (Author), Sax, P.E (Author), Thakarar, K. (Author)
• Format: Article
• Language: English
• Published: Oxford University Press 2022
• Subjects: abacavir; adult; antiretroviral therapy; antiviral activity; antiviral resistance; Article; case report; CD4 lymphocyte count; clinical article; darunavir; DNA strand; dolutegravir; drug efficacy; drug resistance; electroencephalography; emtricitabine; gene mutation; genotype; HIV; human; Human immunodeficiency virus infection; integrase; integrase strand transfer inhibitor; interferon; lamivudine; nonhuman; pre-exposure prophylaxis; programmed death 1 receptor; risk factor; sexual health; stavudine; tenofovir; virus load; virus replication; zidovudine
• Online Access: View Fulltext in Publisher
• ISBN: 23288957 (ISSN)
• DOI: 10.1093/ofid/ofab648

Multiclass high-level transmitted HIV drug resistance is uncommon, and the selection of the optimal initial antiretroviral drug regimen may be challenging. We report a case of extensive transmitted multiclass resistance successfully treated with dolutegravir, tenofovir, and emtricitabine even though the baseline genotype demonstrated full susceptibility to only 1 drug class, integrase strand transfer inhibitors. Our case highlights both the high resistance barrier of dolutegravir and the residual antiviral activity of nucleoside reverse transcriptase inhibitors despite extensive resistance on genotype. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.