Produção Nacional
Revisado por pares
Discordances between Interpretation Algorithms for Genotypic Resistance to Protease and Reverse Transcriptase Inhibitors of Human Immunodeficiency Virus Are Subtype Dependent
2006; American Society for Microbiology; Volume: 50; Issue: 2 Linguagem: Inglês
10.1128/aac.50.2.694-701.2006
ISSN1098-6596
AutoresJoke Snoeck, Rami Kantor, Robert W. Shafer, Kristel Van Laethem, Koen Deforche, A.P. Carvalho, Brian Wynhoven, Marcelo A. Soares, Patricia Cane, John Clarke, Candice Pillay, Sunee Sirivichayakul, Koya Ariyoshi, África Holguín, H Rudich, Rosângela Rodrigues, María Belén Bouzas, Françoise Brun‐Vézinet, Caroline Reid, Pedro Cahn, Luís Fernando de Macedo Brígido, Zehava Grossman, Vincent Soriano, Wataru Sugiura, Praphan Phanuphak, Lynn Morris, Jonathan Weber, Deenan Pillay, Amílcar Tanuri, Richard Harrigan, Ricardo Camacho, Jonathan Schapiro, David Katzenstein, Anne–Mieke Vandamme,
Tópico(s)Renal Transplantation Outcomes and Treatments
ResumoThe major limitation of drug resistance genotyping for human immunodeficiency virus remains the interpretation of the results. We evaluated the concordance in predicting therapy response between four different interpretation algorithms (Rega 6.3, HIVDB-08/04, ANRS [07/04], and VGI 8.0). Sequences were gathered through a worldwide effort to establish a database of non-B subtype sequences, and demographic and clinical information about the patients was gathered. The most concordant results were found for nonnucleoside reverse transcriptase (RT) inhibitors (93%), followed by protease inhibitors (84%) and nucleoside RT inhibitor (NRTIs) (76%). For therapy-naive patients, for nelfinavir, especially for subtypes C and G, the discordances were driven mainly by the protease (PRO) mutational pattern 82I/V + 63P + 36I/V for subtype C and 82I + 63P + 36I + 20I for subtype G. Subtype F displayed more discordances for ritonavir in untreated patients due to the combined presence of PRO 20R and 10I/V. In therapy-experienced patients, subtype G displayed a lot of discordances for saquinavir and indinavir due to mutational patterns involving PRO 90 M and 82I. Subtype F had more discordance for nelfinavir attributable to the presence of PRO 88S and 82A + 54V. For the NRTIs lamivudine and emtricitabine, CRF01_AE had more discordances than subtype B due to the presence of RT mutational patterns 65R + 115 M and 118I + 215Y, respectively. Overall, the different algorithms agreed well on the level of resistance scored, but some of the discordances could be attributed to specific (subtype-dependent) combinations of mutations. It is not yet known whether therapy response is subtype dependent, but the advice given to clinicians based on a genotypic interpretation algorithm differs according to the subtype.
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