| Abstrakt: |
Surveillance of drug resistance mutations in antiretroviral-experienced HIVpatients may provide useful information regarding options available for rescue interventions. All resistance tests performed from 1999 to 2005 on antiretroviral-experienced individuals at one reference laboratory in Madrid were examined. Only mutations associated with drug resistance recorded at the September 2006 IAS-USA list were considered. A total of 2137 specimens were analyzed. Overall, 71.1 showed resistance mutations to at least one drug class, 56.1 to at least two, and 21 to all three drug families. Resistance mutations were 65 for NRTI, 44.4 for NNRTI, and 42.5 for PI. Mutations T215YF, M184V, and M41L were the most frequent for NRTI. Their rate significantly declined since 1999. K65R significantly increased since 1999 (0.8) to 2003 (7.3) but declined up to 3.3 in 2005. For NNRTI, K103N significantly increased from 21.8 in 1999 to 29.5 in 2005 (p< 0.01). The most frequent PI resistance mutations were L90M (24.3), V82X (19.9), M46IL (19.5), and I54V (17.1). The presence of five or more was 58.8 in 1999 but declined to 22.2 in 2005. The rate of drug resistance mutations causing NRTI and PI resistance has steadily declined in antiretroviral-experienced patients since 1999. The availability of a large number andor more convenient NRTI as well as the wide use of ritonavir-boosted PI could explain these observations. However, broad PI cross-resistance was seen in nearly 25 of antiretroviral-experienced patients in 2005. Therefore, there is a still need for new antiretrovirals with different resistance profiles. [ABSTRACT FROM AUTHOR] |
