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ObjectivesThe aim of the study was to investigate whether lamivudine (3TC) or emtricitabine (FTC) use following detection of M184V/I is associated with better virological outcomes.MethodsWe identified people with viruses harbouring the M184V/I mutation in UK multicentre data sets who had treatment change/initiation within 1 year. We analysed outcomes of viral suppression (ResultsWe included 2597 people with the M184V/I resistance mutation, of whom 665 (25.6%) were on 3TC and 458 (17.6%) on FTC. We found a negative adjusted association between 3TC/FTC use and viral suppression [hazard ratio (HR) 0.84; 95% credibility interval (CrI) 0.71-0.98]. On subgroup analysis of individual drugs, there was no evidence of an association with viral suppression for 3TC (n = 184; HR 0.94; 95% CrI 0.73-1.15) or FTC (n = 454; HR 0.99; 95% CrI 0.80-1.19) amongst those on tenofovir-containing regimens, but we estimated a reduced rate of viral suppression for people on 3TC amongst those without tenofovir use (n = 481; HR 0.71; 95% CrI 0.54-0.90). We found no association between 3TC/FTC and detection of any new DRM (overall HR 0.92; 95% CrI 0.64-1.18), but found inconclusive evidence of a lower incidence rate of new DRMs (overall incidence rate ratio 0.69; 95% CrI 0.34-1.11).ConclusionsWe did not find evidence that 3TC or FTC use is associated with an increase in viral suppression, but it may reduce the appearance of additional DRMs in people with M184V/I. 3TC was associated with reduced viral suppression amongst people on regimens without tenofovir.

Original publication

DOI

10.1111/hiv.12829

Type

Journal article

Journal

HIV medicine

Publication Date

05/2020

Volume

21

Pages

309 - 321

Addresses

Institute for Global Health, University College London, London, UK.

Keywords

UK HIV Drug Resistance Database and the UK Collaborative HIV Cohort, Humans, HIV-1, HIV Infections, Lamivudine, Anti-HIV Agents, Treatment Failure, Drug Therapy, Combination, Drug Resistance, Viral, Mutation, Adult, Female, Male, Tenofovir, Emtricitabine, United Kingdom