This finding can probably explain why patients in the EASIER trial had controlled viraemia under an enfuvirtide-containing regimen for a median of 2.2 years. The presence of archived resistance mutations may particularly jeopardize treatment this website outcome when the drugs concerned are included in the regimen. Further prospective studies evaluating the efficacy of the antiretroviral regimen according to DNA genotype results are needed. In conclusion, in patients with past episodes of antiretroviral failure who have suppressed plasma HIV levels under their current regimen, resistance testing performed on HIV DNA lacks sensitivity compared
with cumulated drug resistances from previous plasma genotypes and therefore cannot be used on its own to select an active antiretroviral regimen. Of note, for more recent antiretrovirals, interpretation of past RNA genotypes may be less informative, suggesting the need to reinterpret RT and PR sequences with more recent algorithms. Our study was performed in heavily pretreated patients and the conclusions may not directly apply to patients with less extensive exposure to antiretrovirals. In contrast, analysis of resistance in DNA in naïve patients find more has been shown to be useful and more informative than standard RNA genotyping [31, 32], probably because resistance acquired at the time of primary infection massively fuels the cellular reservoir and persists for long periods of time [33-36]. Our results
have Fossariinae implications for the clinical management of patients, and the design of switch studies. In the absence of available therapeutic history and/or previous plasma genotypes, the use of resistance genotyping of proviral DNA is possible but its limitations must be taken into account when interpreting the results. The detection of even low numbers of resistance mutations reflects the accumulation
of resistance during past therapy. Drug resistance in proviral DNA can be used to inform therapy decisions, such as the choice of drugs with a higher genetic barrier and no cross-resistance. Conflict of interest: CD and JMM: National Board membership. MSD, JB, IC, SD, MLN, NDC, TM, BM, FS and JPA have no conflict of interest to declare. “
“The aim of the study was to assess pregnancy complications in HIV-positive women and changes in the rates of such complications over 11 years in the Frankfurt HIV Cohort. There were 330 pregnancies in HIV-positive women between 1 January 2002 and 31 December 2012. The rate of pregnancy-related complications, such as gestational diabetes mellitus (GDM), pre-eclampsia and preterm delivery, the mode of delivery and obstetric history were analysed. Maternal and neonatal morbidity/mortality as well as HIV mother-to-child transmission (MTCT) were evaluated. In our cohort, GDM was diagnosed in 38 of 330 women (11.4%). Five women (1.5%) developed pre-eclamspia or hypertension. In 16 women (4.8%), premature rupture of membranes (PROM) occurred and 46 women (13.