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Rapid development of drug resistance during initial dolutegravir-based antiretroviral therapy of an infant with HIV

Article scientifique 2025 Anglais

Résumé

Dolutegravir resistance is predominantly reported in antiretroviral therapy-experienced individuals. We describe an infant who developed high-level resistance to abacavir, lamivudine, and dolutegravir within 97 days of initiation, despite initial wild-type infection. Causative factors likely include probable sub-therapeutic antiretroviral drug levels, poor tolerance, severe immunocompromise, and a high pre-treatment viral load. What this study adds: The evolution of DTG resistance from a confirmed transmitted wild-type virus in this infant is more rapid than previously described. Identification of risk factors for developing DTG resistance in infants requires further investigation.

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O’Connell, N., Mollendorff, T., Zyl, G., Korsman, S., Nuttall, J. (2025). Rapid development of drug resistance during initial dolutegravir-based antiretroviral therapy of an infant with HIV. https://doi.org/10.4102/sajhivmed.v26i1.1750

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Auteur(s)

Natasha O’Connell Tara-Lee von Mollendorff Gert U. van Zyl Stephen N.J. Korsman James Nuttall

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