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NNRTINon-Nucleoside Reverse Transcriptase Inhibitor
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The combination of the INSTI DTG plus the NNRTI RPV may be considered as an alternative (5).
Factors associated with VF after age 10 * Sex Male 1 Female 1.44 0.64-3.24 0.378 Type of regimen NNRTI-based 1 PI-based 0.75 0.25-2.27 0.612 Age at ART start (years) 1.11 0.93-1.32 0.232 Programme year 2002 1 2003 1.52 0.54-4.25 0.428 2004 1.51 0.37-6.07 0.563 2005 2.20 0.41-11.98 0.360 Previous VF <10 years old 3.20 1.05-9.75 0.040 CD4+ <350 cells/[micro]L at 4.05 1.04-15.82 0.044 age 10 VF = viral failure; HR = hazard ratio; CI = confidence interval; NNRTI = non-nucleoside reverse transcriptase inhibitor; PI = protease inhibitor; ART = antiretroviral therapy; VL = viral load.
These second- or third-line regimens following PI-based ART usually include integrase strand transfer inhibitors (INSTIs), a PI (older or new generation) and possibly an NNRTI (new generation).
For the 27 RT sequences evaluated we observed NNRTI resistance associated mutations in 11 of the 27 sequences (40.7%).
PI mutations detected were L90M, L10F, NRTI mutations included M41L, A62V, M184V, D67N, L210W, T215Y and K219N and NNRTI mutations were K101Q and Y181I.
In relation to the pharmacological treatment, the 16.7% of patients receiving IP/r were taking lopinavir/ritonavir and almost all of the 83.3% of individuals who received NNRTI were taking efavirenz; nevertheless we did not find any correlation between antiretroviral classes and the levels of the analyzed parameters, perhaps due to the short period of therapy using.
These include: an INSTI, a boosted PI, or, in some situations, an NNRTI. The DHHS guidelines panel currently recommends 6 different ART combinations as first-line treatment in treatment-naive patients (table 2).
The recommended regimen based on two NRTI (Nucleoside reverse transcriptase inhibitor) plus one NNRTI (Non-nucleoside reverse transcriptase inhibitor) or boosted Protease inhibitor.