Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures

Revista do Instituto de Medicina Tropical de São Paulo

Lizeth Taylor-castillo²  Gisela Herrera-martínez¹  María Paz León-bratti¹  Ricardo Boza¹  Bernal León-rodríguez²  Ronald B. Luftig²  Kirsten Visoná² 

[1] ,Louisiana State University International Center for Medical Research and training San José,Costa Rica

关键词: Human immunodeficiency virus;    Anti-retroviral treatment;    Resistance mutations;    Highly active antiretroviral therapy;    Risk factors;    Response;    Adherence;   

DOI  :  10.1590/S0036-46652005000600004

来源: SciELO

【 摘 要 】

INTRODUCTION: Information about HIV phenotypes of resistant to available ART and the influence of different risk factors on virological failures (VF) in Costa Rican HIV positive patients prior or during HAART is unknown. MATERIALS AND METHODS: Eighty nine samples, 72 VF and 17 basal (before treatment) were analyzed by examining resistant mutants in reverse transcriptase (RT) and protease (PT) regions using Trugene or LIPA genotyping kits. Sixty eight control patients were selected and relevant information was collected in a questionnaire. RESULTS: Poor adherence, presence of resistant mutations and number of treatment's changes were the only significant factors found (p = 0.006, 0.04 and 0.01 respectively). From 66 sequenced samples, 78%, 50% and 50% showed resistance to NRTI (nucleoside reverse transcriptase inhibitors), NNRT (non-nucleoside reverse transcriptase inhibitors) and PI (protease inhibitors), respectively. The most frequent mutations were M41L, M184V, and T215FY in RT and L62PI, L10FIRV and M36I in PT. DISCUSSION: The most important factor related to treatment response in this study was adherence to treatment. Mutations in RT were related to the treatment failure while the ones found in PT were secondary mutations which have been previously described to influence the selection of primary resistance mutations in these regions. The study reveals the urgency to detect resistant mutations in VF to be considered by physicians for selection of treatment schedule, to analyze basal HIV patients for monitoring of the spread of resistant mutations and the importance to reinforce the adherence in the patients for overall treatment outcome.

【 授权许可】

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