HIV-1-infected patients with advanced disease failing a raltegravir-containing salvage regimen in São Paulo, Brazil
| Autor: | Jaqueline, de Souza Cavalcanti, Joao Leandro, de Paula Ferreira, Jose Ernesto, Vidal, Paula Morena, de Souza Guimarães, Denise Helena, Moreira, Luis Fernando, de Macedo Brigido, Valeria, Almeida |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty animal structures Anti-HIV Agents Population Mutation Missense Salvage therapy Integrase inhibitor Young Adult Antiretroviral Therapy Highly Active Raltegravir Potassium Internal medicine Drug Resistance Viral Prevalence medicine Humans Pharmacology (medical) Treatment Failure education Darunavir Salvage Therapy Acquired Immunodeficiency Syndrome education.field_of_study business.industry HIV Lamivudine Sequence Analysis DNA General Medicine Middle Aged Raltegravir Virology Pyrrolidinones Regimen Infectious Diseases Female Ritonavir business Brazil medicine.drug |
| Zdroj: | International Journal of Antimicrobial Agents. 43:287-291 |
| ISSN: | 0924-8579 |
| Popis: | Raltegravir (RAL) is the first licensed antiretroviral integrase inhibitor that may be used both for treatment-naïve human immunodeficiency virus type 1 (HIV-1) patients and for salvage therapy. The Brazilian public free access programme limits its use for salvage therapy, with scarce information regarding RAL resistance from patients failing a RAL-containing salvage regimen. This study evaluated RAL resistance mutations detected by population sequencing in 69 HIV-infected patients with advanced disease failing a RAL-containing regimen in a real-world setting. RAL resistance mutations were identified in 47/69 patients (68%). The most common salvage regimen, used by 56/69 patients (81%), included lamivudine, tenofovir, darunavir/ritonavir and RAL. At failure, major RAL resistance mutations included Q148H/R/K (21/47; 45%), N155H (14/47; 30%), Y143R/H/C (3/47; 6%) and E92Q (1/47; 2%). Most samples with Q148H/R/K also showed G140S/A/C (21/47; 45%). RAL resistance was significantly associated with less than two active drugs in the optimised background therapy regimen at failure [39/39 (100%) vs. 9/17 (53%); P0.001] and with a longer cumulative duration with detectable viraemia (viral load50 copies/mL) (86 weeks vs. 32 weeks; P=0.001). A high frequency of RAL mutations was observed in this study. In addition, these results reinforce the importance of close monitoring of RAL-containing regimens to reduce the time of failure and consequent resistance accumulation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect