Emergence of Drug Resistance Is Associated with an Increased Risk of Death among Patients First Starting HAART

Competing Interests: RSH, DRB, CA, EW, JSGM, and PRH have received honorariums, travel grants to attend conferences, and research grants from pharmaceutical companies working in the area of HIV/AIDS. ABSTRACT Background The impact of the emergence of drug-resistance mutations on mortality is not well characterized in antiretroviral-nao ¨ve patients first starting highly active antiretroviral therapy (HAART). Patients may be able to sustain immunologic function with resistant virus, and there is limited evidence that reduced sensitivity to antiretrovirals leads to rapid disease progression or death. We undertook the present analysis to characterize the determinants of mortality in a prospective cohort study with a median of nearly 5 y of follow-up. The objective of this study was to determine the impact of the emergence of drug-resistance mutations on survival among persons initiating HAART.