Drug-Selected Resistance Mutations and Non-B Subtypes in Antiretroviral-Naive Adults with Established Human Immunodeficiency Virus Infection

• Published in: The Journal of infectious diseases Vol. 188; no. 7; pp. 986 - 991
• Main Authors: Hanna, George J., Balaguera, Henri U., Freedberg, Kenneth A., Werner, Barbara G., Steger Craven, Kathleen A., Craven, Donald E., D’Aquila, Richard T.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.10.2003; University of Chicago Press; Oxford University Press
• Subjects: Adult; Anti-HIV Agents - adverse effects; Anti-HIV Agents - therapeutic use; Base Sequence; Biological and medical sciences; Boston; Drug Resistance, Viral - genetics; Fundamental and applied biological sciences. Psychology; HIV Infections - drug therapy; HIV Infections - virology; HIV Protease - chemistry; HIV Protease - genetics; HIV Reverse Transcriptase - chemistry; HIV Reverse Transcriptase - genetics; HIV-1 - classification; HIV-1 - genetics; Human viral diseases; Humans; Infectious diseases; Medical sciences; Microbiology; Molecular Sequence Data; Phylogeny; Point Mutation - genetics; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral - blood; Selection, Genetic; Sequence Analysis, DNA; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Boston; Human; Immunopathology; Treatment resistance; Typing; Microbiology; AIDS; Immune deficiency; Infection; Microbiological investigation; Viral disease; Adult; Antiviral; Mutation; Subtype
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/378280

The prevalence of human immunodeficiency virus (HIV) type 1 antiretroviral resistance is expected to be higher in recently infected antiretroviral-naive individuals than in those who have been infected longer. Antiretroviral-naive HIV-1–infected adults who presented to an outpatient clinic in an urban hospital in Boston for initial evaluation in 1999 were screened for drug-selected resistance mutations and phylogenetic subtype. Drug-selected mutations were identified in 16 (18%) of 88 subjects. Twelve (14%) included mutations associated with nucleoside reverse-transcriptase inhibitors, 4 (5%) included mutations associated with nonnucleoside reverse-transcriptase inhibitors, and 3 (3%) included mutations associated with protease inhibitors. Two (2%) had resistance mutations associated with multiple classes of drugs. Nine (10%) subjects had infection with non-B subtype HIV-1 and did not have drug-selected mutations. Serological results indicated infection for ⩾6 months. Drug-selected mutations or non-B subtypes were detected in a substantial portion of antiretroviral-naive adults who had been infected for at least 6 months