| Autor: |
Pilcher CD; Division of Infectious Diseases, Department of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599-7030, USA. p208470@med.unc.edu, Perkins MD, Fiscus SA, Johnston DM, Dietze R, Duque UH, Zago AM, Assad-Antunes F, Eron JJ |
| Jazyk: |
angličtina |
| Zdroj: |
The Journal of infectious diseases [J Infect Dis] 1999 May; Vol. 179 (5), pp. 1259-63. |
| DOI: |
10.1086/314709 |
| Abstrakt: |
Before December 1997, in Espírito Santo, Brazil, combination antiretroviral therapy was used without routine virologic or immunologic monitoring. To examine consequences of therapy in this setting, clinical information, human immunodeficiency virus type 1 (HIV-1) RNA levels, CD4 cell counts, and protease and reverse transcriptase sequences were determined for consecutive HIV-1-infected outpatients. Of 48 treatment-naive individuals, 11 were started on therapy for HIV-related symptoms; however, 44 (92%) had an RNA level >20,000 copies/mL, a CD4 cell count <500/mm3, or symptoms. Eighteen (51%) of 35 patients on therapy had an RNA level >20,000 copies/mL. Nucleoside-resistance mutations were observed in 21 (68%) of 31 nucleoside-experienced subjects. Protease mutations necessary for high-level protease inhibitor (PI) resistance were present together with permissive mutations in 3 of 10 PI-experienced patients. Inability to identify high-risk individuals and to detect virologic failure may limit the effectiveness of antiretroviral drug programs and may promote the spread of drug resistance where virologic and immunologic monitoring are not available. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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