{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:21:57Z","timestamp":1788312117115,"version":"build-2803163510"},"reference-count":38,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T00:00:00Z","timestamp":1637798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>\n                    Evidence on the impact of human immunodeficiency virus (HIV) drug resistance on regimens following treatment failure is varied and inconclusive. Differential medication adherence may explain this variation. We aimed to test the association between drug resistance at first-line antiretroviral therapy (ART) switch and adherence to and virologic failure on subsequent ART. We conducted a secondary analysis of data from an open-labeled randomized trial of second-line ART (ACTG A5234). ART susceptibility was determined from study entry plasma using the Stanford Drug Resistance database version 8.7. Adherence was measured with microelectronic monitors. Three adherence variables and rates of virologic failure (HIV-1 RNA \u22651000 copies\/mL) on second-line ART were compared between participants with and without resistance at first-line ART failure. Of 214 participants switching to second-line ART with baseline resistance results, 113 (53%) were men, mean age was 39 years (standard deviation 10.3), and 37 (17%) had susceptible virus at study entry. Cumulative genotypic susceptibility score (cGSS) was inversely associated with adherence, adjusted odds ratio (aOR) 0.15, 95% confidence interval (CI) (0.05\u20130.40),\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001. The aOR of virologic failure for a one-unit increase in cGSS was 1.72, 95% CI (1.22\u20132.41),\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001. Participants switched to second-line ART without resistance displayed inferior adherence and had higher rates of virologic failure. Therefore, these individuals warrant additional adherence interventions to help them achieve virologic success.\n                  <\/jats:p>\n                  <jats:p>Clinical Trial Registration number: NCT 00608569.<\/jats:p>","DOI":"10.1089\/apc.2021.0115","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T17:00:45Z","timestamp":1637168445000},"page":"467-473","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Participants Switching to Second-Line Antiretroviral Therapy with Susceptible Virus Display Inferior Adherence and Worse Outcomes: An Observational Analysis"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5785-6809","authenticated-orcid":false,"given":"Lentlametse","family":"Mantshonyane","sequence":"first","affiliation":[{"name":"Botswana University of Pennsylvania Partnership, Gaborone, Botswana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, Rutgers University, New Brunswick, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Z.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole L.","family":"Wallis","sequence":"additional","affiliation":[{"name":"Molecular Division, BARC-SA and Lancet Laboratories, Johannesburg, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrine","family":"Bar","sequence":"additional","affiliation":[{"name":"Molecular Division, BARC-SA and Lancet Laboratories, Johannesburg, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Office of the Global AIDS Coordinator, US Department of State, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Collier","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, University of Washington School of Medicine, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"LaRosa","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n Civil Impacta Salud y Educaci\u00f3n, Lima, Per\u00fa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Harvard T.H. 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