In the START Study, HIV Drug–Resistance Mutations Were Associated with Treatment Failure

Sequencing of START samples revealed increased risk for treatment failure when drug-resistance mutations were detected, even at low population thresholds.

The START study showed that immediate antiretroviral therapy (ART) initiation had a clinical benefit over delayed ART (NEJM JW Infect Dis Jul 20 2015 and N Engl J Med 2015 Aug 27; 373:795). For this substudy, stored plasma samples from participants with baseline HIV RNA levels >1000 copies/mL were analyzed using next-generation sequencing (NGS) to detect drug-resistance mutations (DRMs). The genotypic susceptibility score (GSS), an indicator of drug activity for the initial ART regimen, was then calculated, and risk for treatment failure (defined as viral load >200 copies/mL) was evaluated for GSS scores of 3 versus ≤2.75 (i.e., fewer than 3 active drugs) among participants who started ART regimens containing multiple drugs (detection thres…

Reviewing Author

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

In the START Study, HIV Drug–Resistance Mutations Were Associated with Treatment Failure

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Reviewing Author