{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:28:24Z","timestamp":1781656104967,"version":"3.54.5"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T00:00:00Z","timestamp":1603411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["177499"],"award-info":[{"award-number":["177499"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["179 571"],"award-info":[{"award-number":["179 571"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"SHCS Research Foundation"},{"name":"Yvonne Jacob Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Integrase strand transfer inhibitors (InSTIs) are recommended for first-line treatment of persons with human immunodeficiency virus (HIV). We identified risk factors, including baseline minor InSTI resistance mutations, for treatment failure of InSTI-based regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied time-to-treatment failure and time to viral suppression among 1419 drug-naive patients in the Swiss HIV Cohort Study. We performed Cox regression models adjusted for demographic factors, baseline HIV RNA\/CD4 cell counts, AIDS-defining events, and the type of InSTI. In 646 patients with a baseline genotypic resistance test of the integrase, we studied the impact of minor integrase resistance mutations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed 121 virological failures during 18 447 person-years of follow-up. A baseline viral load \u2265100 000 copies\/mL (multivariable hazard ratio [mHR], 2.2; 95% confidence interval [CI], 1.3\u20133.6) and an AIDS-defining event (mHR, 1.8; 95% CI. 1.1\u20133.0) were associated with treatment failure. CD4 counts between 200 and 500 cells\/\u00b5L (mHR, 0.5; 95% CI, .3\u2013.8) and &amp;gt;500 cells\/\u00b5L (mHR, 0.4; 95% CI, .2\u2013.7) were protective. Time to suppression was shorter in lower viral load strata (mHR, 0.7; 95% CI, .6\u2013.8) and in dolutegravir-based therapy (mHR, 1.2; 95% CI, 1.0\u20131.4). Minor resistance mutations were found at baseline in 104 of 646 (16%) patients with no effect on treatment outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Factors associated with treatment failure on InSTI-based first-line regimen remained similar to those of older treatments, in particular high viral load and low CD4 counts.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciaa1614","type":"journal-article","created":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T19:14:32Z","timestamp":1603134872000},"page":"e2134-e2141","source":"Crossref","is-referenced-by-count":41,"title":["Predictors of Virological Failure and Time to Viral Suppression of First-Line Integrase Inhibitor\u2013Based Antiretroviral Treatment"],"prefix":"10.1093","volume":"73","author":[{"given":"Ashima","family":"Pyngottu","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, 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