Baseline HIV type 1 genotypic resistance to a newly added nucleoside analog is predictive of virologic failure of the new therapy
| Autor: | F. Van Wanzeele, Lidia Ruiz, François Schneider, P. Simons, K Van Vaerenbergh, Chris Verhofstede, Philippe Hermans, E. Van Wijngaerden, Jan Desmyter, B. Clotet, G. M Uyldermans, Anne-Mieke Vandamme, Lieven Stuyver, C. Evans, Jean-Claude Schmit, K. Van Laethem, E. De Clercq |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
Genotype Immunology HIV Infections Biology Polymerase Chain Reaction Nucleoside Reverse Transcriptase Inhibitor Zidovudine Zalcitabine Predictive Value of Tests Virology medicine Humans Didanosine Retrospective Studies Nucleoside analogue virus diseases Lamivudine Drug Resistance Microbial Viral Load Nucleotidyltransferase CD4 Lymphocyte Count Infectious Diseases Predictive value of tests Mutation HIV-1 RNA Viral Reverse Transcriptase Inhibitors Female sense organs medicine.drug |
| Zdroj: | ResearcherID |
| ISSN: | 0889-2229 |
| Popis: | We evaluated the predictive value of baseline HIV-1 genotypic resistance mutations for failure of a nucleoside reverse transcriptase inhibitor (NRTI) containing therapy. The change in therapy of 88 HIV-1-infected patients was analyzed retrospectively, relating the genotypic resistance profile at baseline to the evolution of viral load and CD4+ T cell counts. Genotypic resistance at baseline and at 6 months was evaluated with the LiPA HIV-1 RT, which detects mutations at codons 41, 69, 70, 74, 184, and 215. At 1 to 3 months after change in therapy, patients without preexisting resistance mutations to the new drug (group S) had a significantly better evolution in viral load (reduction of 0.37 log(10)) compared with patients with known preexisting resistance mutation(s) (group R) (increase of 0.08 log(10)). This difference was particularly striking for patients with the baseline M184V mutation and whose treatment was modified by the addition of lamivudine. After 6 months the median difference in viral load evolution between the two groups increased to 0.61 log(10): the viral load of patients of group S was still 0.18 log(10) below baseline while patients of group R had an increase of 0.43 log(10) in viral load above baseline. Changes in CD4+ T cell counts were not significantly different. The evolution in viral load in HIV-1-infected patients with and without baseline resistance mutation(s) toward a newly added NRTI is significantly different at 1-3 months and at 6 months after changing or adding one NRTI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|