{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:52:21Z","timestamp":1762005141372,"version":"3.37.3"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,10,12]],"date-time":"2019-10-12T00:00:00Z","timestamp":1570838400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antiretroviral drug resistance mutations remain a major cause of treatment failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the impact of NRTI resistance mutations on virological effectiveness of elvitegravir-containing regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We selected treatment-experienced HIV-1-infected patients starting elvitegravir\/cobicistat\/emtricitabine\/tenofovir alafenamide (E\/C\/F\/TAF) or elvitegravir\/cobicistat\/emtricitabine\/tenofovir disoproxil fumarate (E\/C\/F\/TDF), with at least one protease\/reverse transcriptase genotype available before switching and at least one HIV-1 RNA viral load (VL) measurement during follow-up. The primary endpoint was virological failure (VF), defined as one VL value of \u22651000\u2009copies\/mL or two consecutive VL values of &amp;gt;50\u2009copies\/mL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 264 ART regimens: 75.6% male, median (IQR) age 47\u2009years (39\u201353), 7\u2009years (3\u201316) of HIV infection, nadir CD4+ 247\u2009cells\/mm3 (105\u2013361), 81.5% with VL \u226450\u2009copies\/mL and 11.7% with at least one NRTI mutation at baseline. Eleven (5.2%) VFs occurred in virologically suppressed patients versus eight (15.1%) in viraemic patients. The estimated probability of VF at 48\u2009weeks with versus without any NRTI mutation was 7.4% (95% CI 2.3\u201312.5) versus 3.8% (2.1\u20135.5) in virologically suppressed patients and 66.7% (39.5\u201393.9) versus 11.2% (6.5\u201315.9) (P&amp;lt;0.001) in viraemic patients. The only predictor of VF was time on therapy (per 1\u2009year more, adjusted HR 1.14, 95% CI 1.02\u20131.27, P=0.024) in viraemic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A switch to E\/C\/F\/TDF or E\/C\/F\/TAF is safe for virologically suppressed patients without documented NRTI resistance, but not recommended in viraemic patients with a history of NRTI resistance. Although we did not detect a detrimental effect of past NRTI resistance in virologically suppressed patients, a fully active regimen remains preferred in this setting due to possible rebound of drug-resistant virus in the long term.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkz424","type":"journal-article","created":{"date-parts":[[2019,9,14]],"date-time":"2019-09-14T11:41:19Z","timestamp":1568461279000},"page":"194-199","source":"Crossref","is-referenced-by-count":2,"title":["Impact of NRTI resistance mutations on virological effectiveness of antiretroviral regimens containing elvitegravir: a multi-cohort study"],"prefix":"10.1093","volume":"75","author":[{"given":"Sara","family":"Modica","sequence":"first","affiliation":[{"name":"Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Redi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100, Siena, Italy"},{"name":"Infectious Diseases Unit, AOU Senese, Viale Bracci, 16, 53100, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Gagliardini","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Via Portuense, 292, 00161, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela","family":"Giombini","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Via Portuense, 292, 00161, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"Bezenchek","sequence":"additional","affiliation":[{"name":"InformaPRO, via Guido Guinizelli, 98\/100, 00152, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"University of Milan, Pediatric Clinical Research Center \u2018Romeo and Enrica Invernizzi\u2019, Via Giovanni Battista Grassi, 74, 20157, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Maggiolo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Ospedali Riuniti, Largo Barozzi, 1, 24128, Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Lombardi","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Roma, Italia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Borghetti","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Roma, Italia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damiano","family":"Farinacci","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Roma, Italia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annapaola","family":"Callegaro","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, Bergamo Hospital, Piazza OMS, 1, 24127, Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria R","family":"Gismondo","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Ospedale L. Sacco, Via G.B Grassi, 74, 20157, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Colafigli","sequence":"additional","affiliation":[{"name":"San Gallicano Dermatologic Institute, STI\/HIV Unit, IRCCS, via Elio Chianesi, 53, 00144, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0385-0903","authenticated-orcid":false,"given":"Gaetana","family":"Sterrantino","sequence":"additional","affiliation":[{"name":"Department di Clinical and Experimental Medicine, Clinic of Tropical and Infectious Diseases, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Costantini","sequence":"additional","affiliation":[{"name":"Clinical Immunology Unit, Department of Clinical and Molecular Sciences, Universit\u00e0 Politecnica delle Marche, Via Tronto, 10, 60121, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio M","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Azienda ospedaliera-Universitaria Ospedali Riuniti, Viale Luigi Pinto, 1, 71122, Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Rusconi","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, DIBIC L. 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