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Göteborgs universitets publikationer

Selection of drug-resistant HIV-1 during the early phase of viral decay is uncommon in treatment-naive patients initiated on a three- or four-drug antiretroviral regimen including lamivudine

Författare och institution:
T. Bergroth (-); H. Ekici (-); Magnus Gisslén (Institutionen för biomedicin, avdelningen för infektionssjukdomar); S. K. Loes (-); L. E. Goh (-); A. Freedman (-); F. Lampe (-); M. A. Johnson (-); A. Sönnerborg (-)
Publicerad i:
Journal of medical virology, 81 ( 1 ) s. 1-8
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
Therapy failure due to drug resistance development is a common phenomenon in HIV-infected patients. However, when the drug pressure leads to the earliest selection of drug-resistant HIV-1 populations is still unclear. In this study, the extent to which selection of the HIV-1 reverse transcriptase M184I/V mutations occur during the initial phase of viral decay in treatment-naive HIV-1 infected patients receiving antiretroviral therapy (ART) was examined. Plasma virus from three cohorts of treatment-naive patients initiating quadruple (n = 43), triple (n = 14) or dual (n = 15) lamivudine-containing ART were analyzed for M184I/V during the first 6 months of therapy using direct sequencing and a sensitive selective real-time PCR method. Among quadruple ART patients, who all were treated at primary HIV-1 infection, only one patient developed M184V after 6 weeks of therapy, having had wild-type virus at baseline. No mutations were found in chronically infected patients on triple ART. In patients on dual therapy, M184I/V mutants were found frequently. Selection of M184I/V mutants was found to be rare during the initial phase of viral decay after initiation of ART in adherent patients given a three or four-drug combination, in contrast to those receiving a less potent regimen. The results suggest that triple and quadruple lamivudine + PI or PI/r containing ART given to treatment-naive adherent patients is potent enough to prevent development of resistance during the first months of therapy.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Medicinska grundvetenskaper ->
Mikrobiologi inom det medicinska området
Adult, Amino Acid Substitution, Anti-HIV Agents/*therapeutic use, Antiretroviral Therapy, Highly Active/*methods, Cohort Studies, *Drug Resistance, Viral, Female, HIV Infections/*drug therapy/*virology, HIV Reverse Transcriptase/genetics, HIV-1/*drug effects/isolation & purification, Humans, Lamivudine/*therapeutic use, Longitudinal Studies, Male, Middle Aged, Mutation, Missense, Plasma/virology, Polymerase Chain Reaction/methods, *Selection (Genetics), Sequence Analysis, DNA, Viral Load
Postens nummer:
Posten skapad:
2009-01-06 22:01
Posten ändrad:
2012-03-27 14:00

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