Author/Editor     van de Vijver, DAMC; Wensing, AMJ; Asjo, B; Bruckova, L; Bruun-Jorgensen, L; Camacho, R; Horban, A; Linka, M; Lazanas, M; Poljak, M
Title     HIV-1 drug-resistance patterns among patients on failing treatment in a large numver of European countries
Type     članek
Source     Acta Dermatovenerol Alp Pannon Adriat
Vol. and No.     Letnik 19, št. 4
Publication year     2010
Volume     str. 3-9
Language     eng
Abstract     Background: Information about patterns of HIV-1 drug resistance among treatment-exposed patients is crucial for the development of novel effective drugs. Currently no system exists that monitors patterns of resistance in patients failing therapy. Methods: The study included 1,988 HIV-1 sequences from patients experiencing therapy failure collected between 2000 and 2004 in 15 European countries. Genotypic resistance was interpreted using the ANRS algorithm. Phenotypic resistance was predicted using the Virco geno- to phenotype system. Results: 80.7% of the sequences included at least one drug-resistance mutation. Mutations were found for NRTIs (73.5%), NNRTIs (48.5%), and protease inhibitors (35.8%). Ninety percent of sequences with genotypic resistance harbored M184V, M41L, K103N, D67N, and/or T215Y. Among NRTIs, resistance was most frequently predicted for lamivudine. About half of all sequences had reduced susceptibility for NNRTIs. Resistance to most boosted protease inhibitors was found in < 25%. No sequence had resistance to all currently available drugs. Conclusion: Levels of resistance among patients with therapy failure were high. The patterns of resistance reflect resistance to drugs available for a longer time. Fully suppressive regimens can be designed even for the most mutated HIV because boosted protease inhibitors have remained active against most circulating viruses and new drug classes have become available.
Descriptors     HIV INFECTIONS
DRUG RESISTANCE, MICROBIAL
GENOTYPE
PHENOTYPE
MUTATION
HIV PROTEASE
HIV PROTEASE INHIBITORS
REVERSE TRANSCRIPTASE INHIBITORS
BASE SEQUENCE
HIV-1
EUROPE