M184V is a single-base mutation in the YMDD domain of reverse transcriptase (RT). The M184V resistance-associated mutation is related to virological unresponsiveness to lamivudine (3TC) and emtricitabine (FTC) and induces high-level resistance to these two antiretroviral agents. M184V is rapidly selected in the setting of non-suppressive antiretroviral therapy (ART) and accumulates in the HIV reservoir. There were continuous efforts to evaluate the impact of M184V mutation on the treatment outcomes in people with HIV (PWH). Since lamivudine remains an extensively used part of recommended antiretroviral combinations, M184V is commonly detected in patients with virological failure. ART guidelines do not recommend the use of drugs impacted by resistance-associated mutations as they have been confirmed to comprise a risk factor for virological failure. However, previous authors suggest that 3TC/FTC can remain active even in the presence of M184V. Obtaining the viral resistance profile for each individual both treated or ART-naïve is a key challenge for lifelong treatment management.Given the potential benefits of lamivudine in the ART combinations, the investigation of M184V remains of high interest for clinicians and researchers. This is a review of literature for the challenges in treating both naïve and experienced individuals carrying the M184V resistance mutation, including virological failure, virological suppression, and resistance to ART.

Abstract: The COVID-19 pandemic has brought about significant psychological challenges, particularly depressive and anxiety-related behaviors in those who have recovered from the virus. This study focuses on individuals aged 30-75+ to understand the prevalence, severity, and impact of these symptoms. By exploring their lasting consequences and potential risk factors, we aim to provide valuable insights for healthcare and mental health professionals, guiding the development of effective support systems to address the psychological aftermath of COVID-19. In this study, a quantitative research design was used to investigate the effects of depressive and anxiety behaviors in patients aged 30-75+ who had experienced COVID-19. The research employed a cross-sectional approach, collecting data at a specific time to assess the prevalence and severity of depressive and anxiety symptoms in the target population. A total of 422 patients were recruited through convenience sampling from various sources, including healthcare facilities, community organizations, and online platforms. Inclusion criteria encompassed individuals aged 30-75+ who had tested positive for COVID-19 and had recovered from the infection. Those with pre-existing mental health conditions significantly affecting depressive and anxiety symptoms were excluded. The sample was diverse in terms of age, gender, employment status, education level, marital status, and past chronic problems. Data collection involved administering standardized questionnaires, such as the Patient Health Questionnaire (PHQ-9) for depressive behaviors and the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety behaviors. These questionnaires assessed symptom severity, while demographic variables were collected separately. The collected data underwent analysis using the Statistical Package for the Social Sciences (SPSS) software, encompassing descriptive statistics, reliability assessments, normality tests, non-parametric tests for demographic comparisons, correlation analyses, and linear regression. Ethical approval and informed consent were obtained, ensuring participant confidentiality and data privacy. Several limitations were acknowledged, including the cross-sectional design's inability to establish causal relationships, potential selection bias due to convenience sampling, susceptibility to response biases with self-report measures, and assumptions and limitations inherent in statistical tests. Overall, the study aimed to provide insights into the effects of depressive and anxiety behaviors in COVID-19 survivors aged 30-75+ and contribute to the development of targeted interventions and support services for this population. This study explored the impact of depressive and anxiety behaviors in COVID-19 survivors aged 30-75+. It involved data collection through validated questionnaires and rigorous statistical analysis. The findings underscore the importance of tailored interventions and support systems to address the long-term psychological effects of the pandemic. Healthcare professionals, researchers, and policymakers must collaborate to prioritize mental well-being and allocate resources accordingly, ultimately improving the quality of life for survivors.

In the TANGO study, the long-term noninferior efficacy of switching to dolutegravir/lamivudine (DTG/3TC) compared to continuing tenofovir alafenamide–based regimens was demonstrated in treatment-experienced adults with HIV. However, there is limited real-world data comparing the effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide fumarate (BIC/FTC/TAF) and DTG/3TC in Asia. This retrospective observational study, conducted at a designated HIV-care hospital from March 2019 to January 2023, aimed to address this gap. Demographic, clinical, and laboratory data, including HIV viral loads and lipid profiles, were collected and analyzed. The primary outcome was the proportion of patients with HIV RNA <50 copies/mL at week 48 in both groups, utilizing a snapshot, per-protocol–exposed population. A total of 1086 patients were included, with 511 in the DTG/3TC group and 575 in the BIC/FTC/TAF group. At week 48, 98% of patients in the DTG/3TC group and 94% in the BIC/FTC/TAF group achieved HIV RNA <50 copies/mL (p <0.01). Logistic regression analysis identified risk factors for detectable viral loads at week 48, including HIV RNA >100,000 copies/mL (AOR 5.13, 95% CI 1.42–18.53), low-level viremia (AOR 3.91, 95% CI 1.07–14.25), and record of virologic failure ≥2 times (AOR 4.21, 95% CI 1.64–10.85) before the switch. Furthermore, no significant difference was found between the DTG/3TC and BIC/FTC/TAF regimens (AOR: 1.51, 95% CI 0.70–3.24). In conclusion, the study demonstrates that the effectiveness and safety profiles of DTG/3TC and BIC/FTC/TAF were comparable in treatment-experienced adults with HIV, particularly among those with undetectable viral loads at baseline.