{"id":46362,"date":"2023-10-01T07:15:46","date_gmt":"2023-10-01T07:15:46","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=46362"},"modified":"2023-10-05T20:07:35","modified_gmt":"2023-10-05T20:07:35","slug":"mutations-associated-with-resistance-to-dapivirine-vaginal-ring-reported-in-7-38-women-seroconverting-in-the-open-label-hope-study","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/46362","title":{"rendered":"Mutations associated with resistance to dapivirine vaginal ring: reported in 7\/38 women seroconverting in the open-label HOPE study"},"content":{"rendered":"

Kirk Taylor, HIV i-Base<\/strong><\/p>\n

A brief report in JAIDS highlights mutations associated with dapivirine (DPV) resistance in seven women who seroconverted during the open-label MTN-025\/HOPE trial. [1]<\/strong><\/p>\n

These mutations decreased susceptibility to DPV by three-fold for 6\/7 women. \u00a0<\/strong><\/p>\n

During the open-label study, 38\/1456 participants seroconverted and 7\/38 women (18%) developed the following DPV-associated resistance mutations: A98G, K103N, V106M, E138A and V179D.<\/p>\n

DPV resistance did not increase in people who continued to use DPV rings for more than three months after their HIV diagnosis.<\/p>\n

Two DPV-associated mutations (K103N and V179I) were also reported in one woman who did not use the DPV ring, reducing DPV-susceptibility by 9-fold.<\/p>\n

As these are either commonly associated with first-line NNRTIs (efavirenz and nevirapine) this was reported as likely transmission of drug-resistant HIV, rather than recently having developed in relation to DPV use for prevention. [2]<\/p>\n

It is unclear how many of the other cases might also have been due to transmitted drug resistance.<\/p>\n

comment<\/h3>\n

These are important findings, given the low overall efficacy of DPV rings, usually due to low adherence.<\/strong><\/p>\n

Retention after four months dropped to only around 60% and was similar to oral PrEP, in a study from Zimbabwe, reported at IAS 2023. [3]<\/strong><\/p>\n

References<\/p>\n

    \n
  1. Parikh UM et al. HIV drug resistance assessment among women who seroconverted during the MTN-025\/HOPE open-label extension dapivirine vaginal ring trial. JAIDS. DOI: 10.97\/QAI.0000000000003308 (20 September 2023).
    \nhttps:\/\/journals.lww.com\/jaids\/abstract\/9900\/hiv_drug_resistance_assessment_among_women_who.299.aspx<\/a><\/li>\n
  2. Stanford drug resistance database. NNRTI Resistance Notes
    \n    https:\/\/hivdb.stanford.edu\/dr-summary\/resistance-notes\/NNRTI<\/a><\/li>\n
  3. Munjoma M et al. Dapivirine vaginal ring (DPV-R): An acceptable and feasible HIV prevention option. Evidence from Zimbabwe. IAS 2023, oral abstract OAD04023.
    \n    https:\/\/programme.ias2023.org\/Abstract\/Abstract\/?abstractid=4452<\/a><\/li>\n<\/ol>\n

    This report was first posted on 25 September 2023.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

    Kirk Taylor, HIV i-Base A brief report in JAIDS highlights mutations associated with dapivirine (DPV) resistance in seven women who seroconverted during the open-label MTN-025\/HOPE trial. [1] These mutations decreased susceptibility to DPV by three-fold for 6\/7 women. \u00a0 During …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[],"class_list":["post-46362","post","type-post","status-publish","format-standard","hentry","category-transmission-and-prevention"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/46362","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=46362"}],"version-history":[{"count":8,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/46362\/revisions"}],"predecessor-version":[{"id":46490,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/46362\/revisions\/46490"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=46362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=46362"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=46362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}