{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:03:43Z","timestamp":1775059423919,"version":"3.50.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Centre of Excellence"},{"DOI":"10.13039\/501100008956","name":"National AIDS Control Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008956","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In low- and middle-income countries where most patients receive standardized third-line ART through national programmes, real-world data are scarce. This study was done to assess the long-term survival, and virological and mutational outcomes of people living with HIV receiving third-line ART between July 2016 and December 2019 in an ART centre in India.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Eighty-five patients were started on third-line ART. Genotypic resistance testing to identify drug resistance mutations in the integrase, reverse transcriptase and protease genes was done at the start of third-line therapy, as well as in those who did not attain virological suppression after 12 months of therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Survival was 85% (72\/85) at 12 months and 72% (61\/85) at the end of follow-up in March 2022. Virological suppression was present in 82% (59\/72) and 88% (59\/67) at 12 months and at the end of follow-up, respectively. Five out of 13 patients who had virological failure at 12 months showed virological suppression at the end of the study. At the start of third-line therapy, 35% (14\/40) and 45% (17\/38) of patients had major integrase- and protease-associated mutations, respectively, even though they had never been on integrase inhibitor-based regimens. At 1 year follow-up, among those failing third-line therapy, 33% (4\/12) of patients had major integrase mutations, but none had major protease mutations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study demonstrates good long-term outcome in patients on standardized third-line ART in programmatic conditions with very few mutations in those failing the therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad111","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T10:14:53Z","timestamp":1681294493000},"page":"1480-1487","source":"Crossref","is-referenced-by-count":3,"title":["Long-term treatment outcome and mutational analysis of patients on third-line antiretroviral therapy in programmatic conditions"],"prefix":"10.1093","volume":"78","author":[{"given":"Jaya","family":"Chakravarty","sequence":"first","affiliation":[{"name":"Department of Medicine, Institute of Medical Sciences, Banaras Hindu University , Varanasi 221005 , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shweta","family":"Srivastva","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Medical Sciences, Banaras Hindu University , Varanasi 221005 , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5558-0204","authenticated-orcid":false,"given":"Anurag Kumar","family":"Kushwaha","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Medical Sciences, Banaras Hindu University , Varanasi 221005 , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arijit","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Medical Sciences, Banaras Hindu University , Varanasi 221005 , India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"2023060100350496500_dkad111-B1","author":"National AIDS Control Organization","year":"2021"},{"key":"2023060100350496500_dkad111-B2","author":"National AIDS Control Organization","year":"2021"},{"key":"2023060100350496500_dkad111-B3","author":"WHO","year":"2016"},{"key":"2023060100350496500_dkad111-B4","first-page":"1394","article-title":"Profile of patients undergoing third line anti-retroviral therapy","volume-title":"Int J Adv Med","author":"Maharajan","year":"2020"},{"key":"2023060100350496500_dkad111-B5","doi-asserted-by":"crossref","first-page":"594","DOI":"10.3390\/v13040594","article-title":"HIV-1 subtype C drug resistance mutations in heavily treated patients failing integrase strand transfer inhibitor-based regimens in 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with HIV-1 infection in Sweden 2003\u20132010","volume":"7","author":"Karlsson","year":"2012","journal-title":"PLoS One"},{"key":"2023060100350496500_dkad111-B12","doi-asserted-by":"crossref","first-page":"221","DOI":"10.6026\/97320630012221","article-title":"Effect of HIV-1 subtype C integrase mutations implied using molecular modeling and docking data","volume":"12","author":"Sachithanandham","year":"2016","journal-title":"Bioinformation"},{"key":"2023060100350496500_dkad111-B13","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofy005","article-title":"HIV-1 drug resistance and third-line therapy outcomes in patients failing second-line therapy in Zimbabwe","volume":"5","author":"Chimbetete","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"2023060100350496500_dkad111-B14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0225631","article-title":"Genotyping and outcomes of presumptive second line ART failure cases switched to third line or maintained on second 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