Early assessment of antiretroviral efficacy is critical to prevent the emergence of resistance mutations in HIV-tuberculosis coinfected patients: a substudy of the CARINEMO-ANRS12146 trial

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Antiretroviral therapy (ART) aims to sustain virological suppression, which is associated with a clinical benefit and immune recovery. It also prevents HIV transmission and limits the emergence of antiretroviral (ARV) drug resistance. In a recent meta-analysis, Gupta. In 2016, 80% of the worldwide prescription of ART-included efavirenz (EFV), a non-nucleoside reverse-transcriptase inhibitor (NNRTI)-class drug. The phase 3 CARINEMO randomized clinical trial enrolled 570 HIV-TB coinfected patients in Mozambique, Africa, and compared the efficacy and safety of two NNRTIs (nevirapine [NVP] and EFV) for ART-naïve patientsn Objectives Course Objective In the CARINEMO ANRS 12146 clinical trial, HIV-tuberculosis co-infected patients in Mozambique were randomized to nevirapine (NVP) or to efavirenz (EFV)-based antiretroviral therapy to compare these two non-nucleoside reverse transcriptase inhibitors (NNRTIs) in treatment naïve patients.. In this sub study, we explored the relationship of NNRTI concentrations with virological escape and the possible emergence of resistance mutations at week 48.