Table of Contents Author Guidelines Submit a Manuscript
AIDS Research and Treatment
Volume 2012, Article ID 934041, 12 pages
http://dx.doi.org/10.1155/2012/934041
Research Article

Prevalence of Drug Resistance and Associated Mutations in a Population of HIV-1+ Puerto Ricans: 2006–2010

1Department of Microbiology and Immunology, Universidad Central del Caribe, P.O. Box 60327, Bayamón, PR 00960-6032, USA
2School of Science and Technology, Universidad Metropolitana, P.O. Box 21150, San Juan, PR 00928-1150, USA

Received 30 September 2011; Revised 30 January 2012; Accepted 13 February 2012

Academic Editor: Ricardo S. Diaz

Copyright © 2012 Lycely del C. Sepúlveda-Torres et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. M. C. Cortés, HIV Incidence and Mortality Data for Puerto Rico: 2006–2011. AIDS Surveillance Program, Office of Research and Epidemiology. Puerto Rico Department of Health, (Personal Communication), San Juan, Puerto Rico, 2012.
  2. CDC, “Subpopulation estimates from the HIV incidence surveillance system-United States, 2006,” Morbidity and Mortality Weekly Report, vol. 57, no. 36, pp. 985–989, 2008. View at Google Scholar · View at Scopus
  3. CDC, “Incidence and diagnoses of HIV infection—Puerto Rico, 2006,” Morbidity and Mortality Weekly Report, vol. 58, no. 21, pp. 589–591, 2009. View at Google Scholar
  4. L. Espinoza, H. I. Hall, R. M. Selik, and X. Hu, “Characteristics of HIV infection among hispanics, united states 2003-2006,” Journal of Acquired Immune Deficiency Syndromes, vol. 49, no. 1, pp. 94–101, 2008. View at Publisher · View at Google Scholar · View at Scopus
  5. CDC, “HIV/AIDS surveillance report, 2006,” Tech. Rep., US Department of Health and Human Services, Atlanta, Ga, USA, 2008. View at Google Scholar
  6. H. I. Hall, R. Song, P. Rhodes et al., “Estimation of HIV incidence in the United States,” Journal of the American Medical Association, vol. 300, no. 5, pp. 520–529, 2008. View at Publisher · View at Google Scholar · View at Scopus
  7. J. C. Reyes, R. R. Robles, H. M. Colón et al., “Homelessness and HIV risk behaviors among drug injectors in Puerto Rico,” Journal of Urban Health, vol. 82, no. 3, pp. 446–455, 2005. View at Publisher · View at Google Scholar · View at Scopus
  8. CDC, “Estimated lifetime risk for diagnosis of HIV infection among Hispanics/Latinos—37 states and Puerto Rico, 2007,” Morbidity and Mortality Weekly Report, vol. 59, no. 40, pp. 1297–1301, 2010. View at Google Scholar
  9. B. K. Madras, “Office of national drug control policy: a scientist in drug policy in Washington, DC,” Annals of the New York Academy of Sciences, vol. 1187, pp. 370–402, 2010. View at Publisher · View at Google Scholar · View at Scopus
  10. A. Anema, A. Levy, K. Johnston, V. D. Lima, and J. Montaner, “Expanded highly active antiretroviral therapy coverage-a powerful strategy to curb progression to AIDS, death and new infections,” European Infectious Disease, vol. 3, no. 1, pp. 41–43, 2009. View at Google Scholar
  11. D. A. Lewis, “Antiretroviral combination therapy for HIV infection,” Dental Update, vol. 30, no. 5, pp. 242–247, 2003. View at Google Scholar · View at Scopus
  12. F. Ceccherini-Silberstein, V. Cento, V. Calvez, and C. F. Perno, “The use of human immunodeficiency virus resistance tests in clinical practice,” Clinical Microbiology and Infection, vol. 16, no. 10, pp. 1511–1517, 2010. View at Publisher · View at Google Scholar · View at Scopus
  13. M. A. Thompson, J. A. Aberg, P. Cahn et al., “Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel,” Journal of the American Medical Association, vol. 304, no. 3, pp. 321–333, 2010. View at Publisher · View at Google Scholar · View at Scopus
  14. Department of Health and Human Services, Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents, Department of Health and Human Services, Washington, DC, USA, 2011.
  15. B. T. Rivera, V. Vallés, and E. Ríos Olivares, “Prevalence of primary and secondary resistant mutations to antiretroviral drug in a population of Puerto Rican infected with HIV,” Puerto Rico Health Sciences Journal, vol. 21, no. 4, pp. 329–336, 2002. View at Google Scholar · View at Scopus
  16. L. A. Cubano, L. D. C. Sepúlveda-Torres, G. Sosa et al., “Prevalence of drug resistance and associated mutations in HIV-positive Puerto ricans: sex variations,” Ethnicity and Disease, vol. 18, no. 2, pp. S2–S2, 2008. View at Google Scholar · View at Scopus
  17. L. A. Cubano, G. Sosa, N. M. Boukli et al., “Prevalence of drug resistance and associated mutations in a population of HIV-1+ Puerto Ricans: 2005,” Boletín de la Asociacion Medica de Puerto Rico, vol. 102, no. 4, pp. 13–17, 2010. View at Google Scholar
  18. V. A. Johnson, F. Brun-Vézinet, B. Clotet et al., “Update of the drug resistance mutations in HIV-1: December 2010,” Topics in HIV Medicine, vol. 18, no. 5, pp. 156–163, 2010. View at Google Scholar
  19. S. Ibe and W. Sugiura, “Clinical significance of HIV reverse-transcriptase inhibitor-resistance mutations,” Future Microbiology, vol. 6, no. 3, pp. 295–315, 2011. View at Publisher · View at Google Scholar
  20. F. Maggiolo, “Efavirenz: a decade of clinical experience in the treatment of HIV,” Journal of Antimicrobial Chemotherapy, vol. 64, no. 5, Article ID dkp334, pp. 910–928, 2009. View at Publisher · View at Google Scholar · View at Scopus
  21. F. Bonura, F. Tramuto, F. Vitale, A. M. Perna, E. Viviano, and N. Romano, “Transmission of drug-resistant HIV type 1 strains in HAART-naive patients: a 5-year retrospective study in sicily, Italy,” AIDS Research and Human Retroviruses, vol. 26, no. 9, pp. 961–965, 2010. View at Publisher · View at Google Scholar · View at Scopus
  22. B. M. Nyombi, C. Holm-Hansen, K. I. Kristiansen, G. Bjune, and F. Müller, “Prevalence of reverse transcriptase and protease mutations associated with antiretroviral drug resistance among drug-naïve HIV-1 infected pregnant women in Kagera and Kilimanjaro regions, Tanzania,” AIDS Research and Therapy, vol. 5, article no. 13, 2008. View at Publisher · View at Google Scholar · View at Scopus
  23. A. G. Marcelin, P. Flandre, J. M. Molina et al., “Genotypic resistance analysis of the virological response to fosamprenavir-ritonavir in protease inhibitor-experienced patients in CONTEXT and TRIAD clinical trials,” Antimicrobial Agents and Chemotherapy, vol. 52, no. 12, pp. 4251–4257, 2008. View at Publisher · View at Google Scholar · View at Scopus
  24. A. Holguin, C. Suñe, F. Hamy, V. Soriano, and T. Klimkait, “Natural polymorphisms in the protease gene modulate the replicative capacity of non-B HIV-1 variants in the absence of drug pressure,” Journal of Clinical Virology, vol. 36, no. 4, pp. 264–271, 2006. View at Publisher · View at Google Scholar · View at Scopus
  25. A. Vinogradova, E. Gafurova, M. Muñoz-Nieto, A. Rakhmanova, S. Osmanov, and M. M. Thomson, “Short communication: molecular epidemiology of HIV type 1 in the republic of dagestan, Russian federation: virtually uniform circulation of subtype A, former soviet union variant, with predominance of the V77IPR subvariant,” AIDS Research and Human Retroviruses, vol. 26, no. 4, pp. 395–400, 2010. View at Publisher · View at Google Scholar · View at Scopus
  26. S. A. Afani, B. C. Beltrán, O. Ana María Gallardo, V. Patricia Roessler, M. William Acevedo, and T. Patricia Vásquez, “Prevalence of primary antiretroviral resistance among HIV infected patients in Chile,” Revista Medica de Chile, vol. 138, no. 6, pp. 669–676, 2010. View at Google Scholar · View at Scopus
  27. I. Pellegrin, D. Breilh, G. Coureau et al., “Interpretation of genotype and pharmacokinetics for resistance to fosamprenavir-ritonavir-based regimens in antiretroviral-experienced patients,” Antimicrobial Agents and Chemotherapy, vol. 51, no. 4, pp. 1473–1480, 2007. View at Publisher · View at Google Scholar · View at Scopus
  28. B. Masquelier, K. L. Assoumou, D. Descamps et al., “Clinically validated mutation scores for HIV-1 resistance to fosamprenavir/ritonavir,” Journal of Antimicrobial Chemotherapy, vol. 61, no. 6, pp. 1362–1368, 2008. View at Publisher · View at Google Scholar · View at Scopus
  29. A. de Luca, S. di Giambenedetto, R. Maserati et al., “Interpretation of genotypic HIV-1 resistance to darunavir and virological response: validation of available systems and of a new score,” Antiviral Therapy, vol. 16, no. 4, pp. 489–497, 2011. View at Publisher · View at Google Scholar
  30. G. Yu, Y. Li, J. Li et al., “Genetic diversity and drug resistance of HIV type 1 circulating recombinant form-bc among drug users in Guangdong Province,” AIDS Research and Human Retroviruses, vol. 25, no. 9, pp. 869–875, 2009. View at Publisher · View at Google Scholar · View at Scopus
  31. S. Hariri and M. T. McKenna, “Epidemiology of human immunodeficiency virus in the United States,” Clinical Microbiology Reviews, vol. 20, no. 3, pp. 478–488, 2007. View at Google Scholar
  32. B. W. Pence, J. Ostermann, V. Kumar, K. Whetten, N. Thielman, and M. J. Mugavero, “The influence of psychosocial characteristics and race/ethnicity on the use, duration, and success of antiretroviral therapy,” Journal of Acquired Immune Deficiency Syndromes, vol. 47, no. 2, pp. 194–201, 2008. View at Publisher · View at Google Scholar · View at Scopus
  33. L. S. Robison, A. O. Westfall, M. J. Mugavero et al., “Short-term discontinuation of HAART regimens more common in vulnerable patient populations,” AIDS Research and Human Retroviruses, vol. 24, no. 11, pp. 1347–1355, 2008. View at Publisher · View at Google Scholar · View at Scopus
  34. C. U. Oramasionwu, J. M. Hunter, J. Skinner et al., “Black race as a predictor of poor health outcomes among a national cohort of HIV/AIDS patients admitted to US hospitals: a cohort study,” BMC Infectious Diseases, vol. 9, p. 127, 2009. View at Publisher · View at Google Scholar · View at Scopus
  35. E. Losina, B. R. Schackman, S. N. Sadownik et al., “Racial and sex disparities in life expectancy losses among hiv-infected persons in the united states: impact of risk behavior, late initiation, and early discontinuation of antiretroviral therapy,” Clinical Infectious Diseases, vol. 49, no. 10, pp. 1570–1578, 2009. View at Publisher · View at Google Scholar · View at Scopus
  36. T. P. Giordano, G. Bartsch, Y. Zhang et al., “Disparities in outcomes for African American and Latino subjects in the Flexible Initial Retrovirus Suppressive Therapies (first) trial,” AIDS Patient Care and STDs, vol. 24, no. 5, pp. 287–295, 2010. View at Publisher · View at Google Scholar · View at Scopus
  37. A. M. Dennis, S. Napravnik, A. C. Seña, and J. J. Eron, “Late entry to HIV care among latinos compared with non-latinos in a southeastern US cohort,” Clinical Infectious Diseases, vol. 53, no. 5, pp. 480–487, 2011. View at Publisher · View at Google Scholar
  38. N. E. Chen, J. E. Gallant, and K. R. Page, “A systematic review of HIV/AIDS survival and delayed diagnosis among hispanics in the United States,” Journal of Immigrant and Minority Health, vol. 14, no. 1, pp. 65–81, 2012. View at Google Scholar
  39. D. C. Lemly, B. E. Shepherd, T. Hulgan et al., “Race and Sex Differences in Antiretroviral Therapy Use and Mortality among HIV-Infected Persons in Care,” Journal of Infectious Diseases, vol. 199, no. 7, pp. 991–998, 2009. View at Publisher · View at Google Scholar · View at Scopus
  40. A. L. Meditz, S. MaWhinney, A. Allshouse et al., “Sex, race, and geographic region influence clinical outcomes following primary HIV-1 infection,” Journal of Infectious Diseases, vol. 203, no. 4, pp. 442–451, 2011. View at Publisher · View at Google Scholar
  41. M. C. Kempf, J. McLeod, A. K. Boehme et al., “A qualitative study of the barriers and facilitators to retention-in-care among HIV-positive women in the rural southeastern united states: implications for targeted interventions,” AIDS Patient Care and STDs, vol. 24, no. 8, pp. 515–520, 2010. View at Publisher · View at Google Scholar · View at Scopus
  42. M. Aziz and K. Y. Smith, “Challenges and successes in linking HIV-infected women to care in the united states,” Clinical Infectious Diseases, vol. 52, supplement 2, pp. S231–S237, 2011. View at Publisher · View at Google Scholar
  43. K. E. Squires, S. L. Hodder, J. Feinberg et al., “Health needs of HIV-infected women in the United States: insights from the women living positive survey,” AIDS Patient Care and STDs, vol. 25, no. 5, pp. 279–285, 2011. View at Publisher · View at Google Scholar
  44. Q. A. Karim, A. Banegura, P. Cahn et al., “Asking the right questions: developing evidence-based strategies for treating HIV in women and children,” BMC Public Health, vol. 11, p. 388, 2011. View at Publisher · View at Google Scholar
  45. J. Whitescarver, Fiscal Year 2012 National Institutes of Health Trans-NIH Aids Research By-Pass Budget Estimate and Trans-NIH Plan for HIV-Related Research, NIH Associate Director for AIDS Research and Director, Office of AIDS Research, Bethesda, Md, USA, 2011.
  46. H. S. Weinstock, I. Zaidi, W. Heneime et al., “The epidemiology of antiretroviral drag resistance among drug-naive HIV-1-infected persons in 10 US cities,” Journal of Infectious Diseases, vol. 189, no. 12, pp. 2174–2180, 2004. View at Publisher · View at Google Scholar · View at Scopus
  47. J. R. Grubb, E. Singhatiraj, K. Mondy, W. G. Powderly, and E. T. Overton, “Patterns of primary antiretroviral drug resistance in antiretroviral-naive HIV-1-infected individuals in a midwest university clinic,” AIDS, vol. 20, no. 16, pp. 2115–2116, 2006. View at Publisher · View at Google Scholar · View at Scopus
  48. S. Yerly, V. Von Wyl, B. Ledergerber et al., “Transmission of HIV-1 drug resistance in Switzerland: a 10-year molecular epidemiology survey,” AIDS, vol. 21, no. 16, pp. 2223–2229, 2007. View at Publisher · View at Google Scholar · View at Scopus
  49. C. L. Gibert, J. C. Shlay, S. Sharma, G. Bartsch, G. Peng, and C. Grunfeld, “Racial differences in changes of metabolic parameters and body composition in antiretroviral therapy-naive persons initiating antiretroviral therapy,” Journal of Acquired Immune Deficiency Syndromes, vol. 50, no. 1, pp. 44–53, 2009. View at Publisher · View at Google Scholar · View at Scopus
  50. E. M. Tedaldi, J. Absalon, A. J. Thomas, J. C. Shlay, and M. Van Den Berg-Wolf, “Ethnicity, race, and gender: differences in serious adverse events among participants in an antiretroviral initiation trial: results of CPCRA 058 (FIRST study),” Journal of Acquired Immune Deficiency Syndromes, vol. 47, no. 4, pp. 441–448, 2008. View at Publisher · View at Google Scholar · View at Scopus
  51. J. Z. Li, R. Paredes, H. J. Ribaudo et al., “Low-frequency HIV-1 drug resistance mutations and risk of NNRTI-based antiretroviral treatment failure: a systematic review and pooled analysis,” Journal of the American Medical Association, vol. 305, no. 13, pp. 1327–1335, 2011. View at Publisher · View at Google Scholar
  52. C. L. Booth, A. M. Garcia-Diaz, M. S. Youle, M. A. Johnson, A. Phillips, and A. M. Geretti, “Prevalence and predictors of antiretroviral drug resistance in newly diagnosed HIV-1 infection,” Journal of Antimicrobial Chemotherapy, vol. 59, no. 3, pp. 517–524, 2007. View at Publisher · View at Google Scholar · View at Scopus
  53. D. Descamps, M. L. Chaix, B. Montes et al., “Increasing prevalence of transmitted drug resistance mutations and non-B subtype circulation in antiretroviral-naive chronically HIV-infected patients from 2001 to 2006/2007 in France,” Journal of Antimicrobial Chemotherapy, vol. 65, no. 12, Article ID dkq380, pp. 2620–2627, 2010. View at Publisher · View at Google Scholar · View at Scopus
  54. D. E. Iarikov, M. Irizarry-Acosta, C. Martorell, R. P. Hoffman, and D. J. Skiest, “Low prevalence of primary HIV resistance in Western Massachusetts,” Journal of the International Association of Physicians in AIDS Care, vol. 9, no. 4, pp. 227–231, 2010. View at Publisher · View at Google Scholar · View at Scopus
  55. V. Mave, M. Gahunia, M. Frontini, R. Clark, and D. Mushatt, “Gender differences in HIV drug resistance mutations and virological outcome,” Journal of Women's Health, vol. 20, no. 1, pp. 117–122, 2011. View at Publisher · View at Google Scholar
  56. I. Ofotokun, S. K. Chuck, and J. E. Hitti, “Antiretroviral pharmacokinetic profile: a review of sex differences,” Gender Medicine, vol. 4, no. 2, pp. 106–119, 2007. View at Publisher · View at Google Scholar · View at Scopus
  57. M. Floridia, M. Giuliano, L. Palmisano, and S. Vella, “Gender differences in the treatment of HIV infection,” Pharmacological Research, vol. 58, no. 3-4, pp. 173–182, 2008. View at Publisher · View at Google Scholar · View at Scopus
  58. J. Currier, D. A. Bridge, D. Hagins et al., “Sex-based outcomes of Darunavir-Ritonavir therapy: a single-group trial,” Annals of Internal Medicine, vol. 153, no. 6, pp. 349–357, 2010. View at Google Scholar · View at Scopus
  59. K. E. Squires, M. Johnson, R. Yang et al., “Comparative gender analysis of the efficacy and safety of atazanavir/ritonavir and lopinavir/ritonavir at 96 weeks in the CASTLE study,” Journal of Antimicrobial Chemotherapy, vol. 66, no. 2, pp. 363–370, 2011. View at Publisher · View at Google Scholar
  60. K. B. Patterson, S. Napravnik, J. Eron, J. Keruly, and R. Moore, “Effects of age and sex on immunological and virological responses to initial highly active antiretroviral therapy,” HIV Medicine, vol. 8, no. 6, pp. 406–410, 2007. View at Publisher · View at Google Scholar · View at Scopus
  61. C. J. Smith, C. A. Sabin, M. S. Youle et al., “Response to efavirenz-containing regimens in previously antiretroviral-naive HIV-positive patients: the role of gender,” Journal of Acquired Immune Deficiency Syndromes, vol. 46, no. 1, pp. 62–67, 2007. View at Publisher · View at Google Scholar · View at Scopus
  62. S. L. Walmsley, K. Squires, L. Weiss et al., “Multidrug-experienced HIV-1-infected women demonstrated similar virological and immunological responses to tipranavir/ritonavir compared with men,” AIDS, vol. 23, no. 3, pp. 429–431, 2009. View at Publisher · View at Google Scholar · View at Scopus
  63. C. S. Krawczyk, E. Funkhouser, J. M. Kilby, and S. H. Vermund, “Delayed access to HIV diagnosis and care: special concerns for the Southern United States,” AIDS Care, vol. 18, no. 1, pp. S35–S44, 2006. View at Publisher · View at Google Scholar · View at Scopus
  64. C. Tapp, M.-J. Milloy, T. Kerr et al., “Female gender predicts lower access and adherence to antiretroviral therapy in a setting of free healthcare,” BMC Infectious Diseases, vol. 11, p. 86, 2011. View at Publisher · View at Google Scholar
  65. C. H. Olsen, A. Mocroft, O. Kirk et al., “Interruption of combination antiretroviral therapy and risk of clinical disease progression to AIDS or death,” HIV Medicine, vol. 8, no. 2, pp. 96–104, 2007. View at Publisher · View at Google Scholar · View at Scopus
  66. T. J. Nicolson, H. R. Mellor, and R. R. A. Roberts, “Gender differences in drug toxicity,” Trends in Pharmacological Sciences, vol. 31, no. 3, pp. 108–114, 2010. View at Publisher · View at Google Scholar · View at Scopus
  67. M. C. Kempf, M. Pisu, A. Dumcheva, A. O. Westfall, J. M. Kilby, and M. S. Saag, “Gender differences in discontinuation of antiretroviral treatment regimens,” Journal of Acquired Immune Deficiency Syndromes, vol. 52, no. 3, pp. 336–341, 2009. View at Publisher · View at Google Scholar · View at Scopus
  68. N. L. Sohler, X. Li, and C. O. Cunningham, “Gender disparities in HIV health care utilization among the severely disadvantaged: can we determine the reasons?” AIDS Patient Care and STDs, vol. 23, no. 9, pp. 775–783, 2009. View at Publisher · View at Google Scholar · View at Scopus
  69. S. Y. Hong, J. B. Nachega, K. Kelley, S. Bertagnolio, V. C. Marconi, and M. R. Jordan, “The global status of HIV drug resistance: clinical and public-health approaches for detection, treatment and prevention,” Infectious Disorders-Drug Targets, vol. 11, no. 2, pp. 124–133, 2011. View at Google Scholar
  70. A. Shet, L. Berry, H. Mohri et al., “Tracking the prevalence of transmitted antiretroviral drug-resistant HIV-1: a decade of experience,” Journal of Acquired Immune Deficiency Syndromes, vol. 41, no. 4, pp. 439–446, 2006. View at Publisher · View at Google Scholar · View at Scopus
  71. C. L. Booth and A. M. Geretti, “Prevalence and determinants of transmitted antiretroviral drug resistance in HIV-1 infection,” Journal of Antimicrobial Chemotherapy, vol. 59, no. 6, pp. 1047–1056, 2007. View at Publisher · View at Google Scholar · View at Scopus
  72. A. F. Y. Poon, J. L. Aldous, W. C. Mathews et al., “Transmitted drug resistance in the CFAR network of integrated clinical systems cohort: prevalence and effects on pre-therapy CD4 and viral load,” PLoS ONE, vol. 6, no. 6, p. e21189, 2011. View at Publisher · View at Google Scholar
  73. L. L. Jagodzinski, J. D. Cooley, M. Weber, and N. L. Michael, “Performance characteristics of human immunodeficiency virus type 1 (HIV-1) genotyping systems in sequence-based analysis of subtypes other than HIV-1 subtype B,” Journal of Clinical Microbiology, vol. 41, no. 3, pp. 998–1003, 2003. View at Publisher · View at Google Scholar · View at Scopus
  74. B. B. Simen, J. F. Simons, K. H. Hullsiek et al., “Low-abundance drug-resistant viral variants in chronically HIV-infected, antiretroviral treatment-naive patients significantly impact treatment outcomes,” Journal of Infectious Diseases, vol. 199, no. 5, pp. 693–701, 2009. View at Publisher · View at Google Scholar · View at Scopus
  75. K. J. Metzner, S. G. Giulieri, S. A. Knoepfel et al., “Minority quasispecies of drug-resistant HIV-1 that lead to early therapy failure in treatment-naive and -adherent patients,” Clinical Infectious Diseases, vol. 48, no. 2, pp. 239–247, 2009. View at Publisher · View at Google Scholar · View at Scopus
  76. R. Paredes, C. M. Lalama, H. J. Ribaudo et al., “Pre-existing minority drug-resistant HIV-1 variants, adherence, and risk of antiretroviral treatment failure,” Journal of Infectious Diseases, vol. 201, no. 5, pp. 662–671, 2010. View at Publisher · View at Google Scholar · View at Scopus
  77. E. K. Halvas, A. Wiegand, V. F. Boltz et al., “Low frequency nonnucleoside reverse-transcriptase inhibitor-resistant variants contribute to failure of efavirenz-containing regimens in treatment- experienced patients,” Journal of Infectious Diseases, vol. 201, no. 5, pp. 672–680, 2010. View at Publisher · View at Google Scholar · View at Scopus
  78. C. Wang, Y. Mitsuya, B. Gharizadeh, M. Ronaghi, and R. W. Shafer, “Characterization of mutation spectra with ultra-deep pyrosequencing: application to HIV-1 drug resistance,” Genome Research, vol. 17, no. 8, pp. 1195–1201, 2007. View at Publisher · View at Google Scholar · View at Scopus
  79. M. Lataillade, J. Chiarella, R. Yang et al., “Prevalence and clinical significance of HIV drug resistance mutations by ultra-deep sequencing in antiretroviral-naïve subjects in the CASTLE study,” PloS one, vol. 5, no. 6, p. e10952, 2010. View at Publisher · View at Google Scholar · View at Scopus
  80. B. Simen, M. S. Braverman, I. Abbate et al., “A multicentre collaborative study on HIV drug resistance testing using 454 massively parallel pyrosequencing,” Antiviral Therapy, vol. 15, supplement 2, p. A37, 2010. View at Google Scholar
  81. R. W. Shafer, “Low-abundance drug-resistant HIV-1 variants: finding significance in an era of abundant diagnostic and therapeutic options,” Journal of Infectious Diseases, vol. 199, no. 5, pp. 610–612, 2009. View at Publisher · View at Google Scholar · View at Scopus
  82. A. Gega and M. J. Kozal, “New technology to detect low-level drug-resistant HIV variants,” Future Virology, vol. 6, no. 1, pp. 17–26, 2011. View at Publisher · View at Google Scholar · View at Scopus