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Low-abundance DRMs from all three antiretroviral classes were detected.
Eight of 22 subjects (36.5%) harbored low-abundance mutations that imparted resistance to a single antiretroviral class; 6 of 22 subjects (27%) harbored resistance to two antiretroviral classes, and 8 of 22 subjects (36.5%) harbored resistance to three antiretroviral classes.
Direct observation of HAART could enhance the health of infants who acquire HIV infection by reducing the probability of primary infection with resistant virus [57], and could also improve future health in the mother by preserving the potency of antiretroviral classes for future use [6].
While hepatotoxicity was described for all antiretroviral classes, ritonavir was attributed the highest risk among all drugs [ 1, 2].
8 Patients with CD4 counts below 200 cells/μL are at higher risk of opportunistic infections, and this correlation is consistent across different antiretroviral classes.
Eligibility criteria included viral load > 500 copies/mL, treatment failure on a regimen containing raltegravir or elvitegravir, and documented resistance to at least one drug from three or more approved antiretroviral classes.
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The most common antiretroviral class utilized was nucleoside reverse transcriptase inhibitors (NRTIs) taken by 81% of participants; the most common NRTI was zidovudine (71%), followed by lamivudine (67%), stavudine (36%), didanosine (29%), tenofovir (21%), and abacavir (20%).
The only antiretroviral class not interfering with the enzymes of the virus is the group of entry inhibitors.
As expected, the occurrence of a previous virological failure increased the risk of resistance to any antiretroviral class.
NRTI resistance in patients assuming any drug of this antiretroviral class was found in association with several independent predictors, including gender, risk factor, age, HIV-1 subtype, viral load at failure, previous virological failures, number of previous antiretroviral regimens, prior exposure to suboptimal NRTI therapy, associated antiretroviral class in use at failure and period of study.
Traditionally, this combination has included two drugs from the antiretroviral class of nucleoside reverse transcriptase inhibitors (NRTIs) and either one from the class of protease inhibitors (PIs) or one from the class of non-nucleoside reverse transcriptase inhibitors (NNRTIs) [ 2].
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