Open AccessOccurrence of the S230R integrase strand inhibitor mutation in a treatment-naïve individual case report
Author(s) -
Smitha Gudipati,
Indira Brar,
Alicia Golembieski,
Zachary Hanna,
Norman Markowitz
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000020915
Subject(s) - medicine , integrase , mutation , genetics , integrase inhibitor , virology , gene , human immunodeficiency virus (hiv) , biology , antiretroviral therapy , viral load
Rationale: Transmitted resistance to integrase strand inhibitors (INSTI) has been uncommon, but is slowly becoming more prevalent among those living with HIV. In an era with 2-drug regimens for antiretroviral therapy, transmitted resistance for INSTI is alarming. Patient concerns: A 28-year-old African American female was recently diagnosed with HIV during a 30-week prenatal visit. Diagnosis: HIV 4th generation test was positive as well as confirmation. Genotype was performed using next generation sequencing. Interventions: Patient was initially rapidly started on a dolutegravir based regimen and changed to a protease inhibitor regimen once her genotype reported an S230R mutation. Outcomes: Patient became virally suppressed on antiretroviral therapy and delivered an HIV negative baby. Lessons: INSTI resistance testing should be done for treatment-naïve and INSTI-naïve persons, particularly when considering 2 drug INSTI based regimens.