Genotypic resistance to antiretroviral drugs in patients with therapeutic failure to highly active antiretroviral therapy

• Published in: Medicina clínica Vol. 115; no. 11; p. 401
• Main Authors: Gutiérrez, F, Moltó, J, Escolano, C, Mora, A, Pasquau, F, Gregori, J, Nogueira, E
• Format: Journal Article
• Language: Spanish
• Published: Spain 07.10.2000
• Subjects: Adult; Aged; Anti-HIV Agents - pharmacology; Antiretroviral Therapy, Highly Active; Drug Resistance, Microbial - genetics; Endopeptidases - genetics; Female; Genotype; HIV - drug effects; HIV - genetics; HIV Infections - drug therapy; HIV Infections - genetics; HIV Infections - virology; HIV Protease Inhibitors - pharmacology; HIV Protease Inhibitors - therapeutic use; HIV-1 - drug effects; HIV-1 - genetics; Humans; Indinavir - pharmacology; Indinavir - therapeutic use; Male; Middle Aged; Mutation; Nevirapine - pharmacology; Nevirapine - therapeutic use; Protease Inhibitors - pharmacology; Reverse Transcriptase Inhibitors - pharmacology; Reverse Transcriptase Inhibitors - therapeutic use; RNA-Directed DNA Polymerase - genetics; Treatment Failure; Zidovudine - pharmacology; Zidovudine - therapeutic use
• ISSN: 0025-7753
• DOI: 10.1016/S0025-7753(00)71574-0

To assess genotypic resistance mutations in patients with virological failure with highly active antiretroviral therapy (HAART) METHODS: Genotyping of reverse transcriptase (RT) and protease (PRO) HIV-1 genes were carried out in 33 adherent patients failing on HAART. Resistance mutations were found in 32 of the 33; 27 of them (81.8%) being primary mutations: 26 (78.8%) in the RT gene and 60 (60.6%) in the PRO gene. Overall, 66.6% had genotypic resistance to two drugs and 60.6% showed resistance to drugs belonging to the two main classes of antiretroviral drugs. At the time of treatment failure, 72.7% had on their therapeutic regimen one antiretroviral drug to which they had resistance mutations, 48.5% had genotypic resistance to two drugs of the therapeutic regimen and 21.2% to three drugs. Most adherent patients failing on HAART carry drug resistant genotypes. These patients may constitute a reservoir of multidrug resistant HIV that may limit treatment options in the future.