Rapid emergence of resistance to antiretroviral treatment after undisclosed prior exposure: A case report

Southern African Journal of HIV Medicine

 
 
Field Value
 
Title Rapid emergence of resistance to antiretroviral treatment after undisclosed prior exposure: A case report
 
Creator Rossouw, Theresa M. van Dyk, Gisela van Zyl, Gert
 
Subject — HIV drug resistance; Antiretroviral therapy; Undisclosed prior treatment
Description Introduction: Patients who disengaged from care may present as therapy naïve for antiretroviral treatment (ART) initiation at a different site, without being recognised as being at an increased risk of rapid treatment failure and HIV drug resistance.Patient presentation: A 43-year-old woman, who gave no prior history of ART, was initiated on a standard first-line regimen of TDF, FTC and EFV. She had a poor response to treatment with evidence of treatment failure at 12 months.Management and outcome: HIV-1 drug resistance tests showed no pre-treatment HIVDR mutations, but revealed high-level drug resistance to all component drugs at 12 months. On investigation, viral load (VL) was recorded in 2012 and 2013, providing evidence of prior ART use.Conclusion: Linkage of patient therapy and laboratory information to unique patient identifiers may allow health-care workers to identify patients who previously received ART and disengaged from care. This will enable differentiated care when these patients reinitiate ART, which should involve expedited VL testing and more rapid transition to definitive second-line ART.
 
Publisher AOSIS
 
Contributor National Research Foundation National Health Laboratory Service Research Trust
Date 2019-07-30
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Case report
Format text/html application/epub+zip application/xml application/pdf
Identifier 10.4102/sajhivmed.v20i1.965
 
Source Southern African Journal of HIV Medicine; Vol 20, No 1 (2019); 3 pages 2078-6751 1608-9693
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://sajhivmed.org.za/index.php/hivmed/article/view/965/1545 https://sajhivmed.org.za/index.php/hivmed/article/view/965/1544 https://sajhivmed.org.za/index.php/hivmed/article/view/965/1546 https://sajhivmed.org.za/index.php/hivmed/article/view/965/1543
 
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Rights Copyright (c) 2019 Theresa M. Rossouw, Gisela van Dyk, Gert van Zyl https://creativecommons.org/licenses/by/4.0
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