Transmission of Human Immunodeficiency Virus I Drug Resistance - a Case Report. What are the Clinical Implications?
| Autor: | Jens Verheyen, Carolynne Schwarze-Zander, Juergen K. Rockstroh, Bernd Kupfer, Jan-Christian Wasmuth, Rolf Kaiser, Eugen Schülter, J Emmelkamp, Evrim Anadol |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Drug Resistance lcsh:Medicine Case Report Drug resistance Biology Human immunodeficiency virus I Zidovudine Drug Resistance Viral medicine Humans Acquired Immunodeficiency Syndrome Reverse-transcriptase inhibitor lcsh:R virus diseases T215 D General Medicine biochemical phenomena metabolism and nutrition transmitted resistance Virology HIV Reverse Transcriptase Reverse transcriptase Atazanavir Mutation Immunology HIV-1 Reverse Transcriptase Inhibitors Female Saquinavir Viral load Nucleoside medicine.drug |
| Zdroj: | European Journal of Medical Research, Vol 15, Iss 5, p 225 (2010) European Journal of Medical Research |
| Popis: | The success of first-line antiretroviral therapy can be challenged by the acquisition of primary drug resistance. Here we report a case where baseline genotypic resistance testing detected resistance conferring nucleoside/nucleotide reverse transcriptase inhibitor (NRTI)-associated mutations, but no primary mutations for protease inhibitor (PI). Subsequent PI-based HAART with boosted saquinavir led to virological treatment success with persistently undetectable viral load. After treatment simplification from saquinavir to an atazanavir based PI-therapy and no change in backbone therapy rapid virological breakthrough occurred. Retrospective analysis displayed preexisting gag cleavage site mutations which may have reduced the genetic barrier in a clinical relevant manner in combination with the already existing NRTI resistance mutations. Alternatively, this effect could be explained with a different antiviral potency for the respective PIs used. |
| Databáze: | OpenAIRE |
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