HIV RNA screening reduces integrase strand transfer inhibitor resistance risk in persons receiving long-acting cabotegravir for HIV prevention
Citation
Eshleman SH, Fogel JM, Halvas EK, Piwowar-Manning E, Marzinke MA, Kofron R, Wang Z, Mellors J, McCauley M, Rinehart AR, Clair MS, Adeyeye A, Hinojosa JC, Cabello R, Middelkoop K, Hanscom B, Cohen MS, Grinsztejn B, Landovitz RJ, HPTN 083 Study Team. HIV RNA screening reduces integrase strand transfer inhibitor resistance risk in persons receiving long-acting cabotegravir for HIV prevention. J Infect Dis.
Abstract
Background: The HPTN 083 trial demonstrated that long-acting cabotegravir (CAB-LA) was superior to tenofovir-disoproxil fumarate/emtricitabine for HIV pre-exposure prophylaxis (PrEP). Integrase strand transfer inhibitor (INSTI) resistance-associated mutations (RAMs) were detected in some participants with HIV infection. We used a low viral load INSTI genotyping assay to evaluate the timing of emergence of INSTI RAMs and assessed whether HIV screening with a sensitive RNA assay would have detected HIV infection before INSTI resistance emerged. Methods: Single-genome sequencing to detect INSTI RAMs was performed for samples with viral loads