Genotypic and Phenotypic Resistance Patterns in Early-Stage HIV-1-Infected Patients Failing Initial Therapy with Stavudine, Didanosine and Nevirapine
2002; SAGE Publishing; Volume: 7; Issue: 4 Linguagem: Inglês
10.1177/135965350200700408
ISSN2040-2058
AutoresCarme Vidal, Mireia Arnedo, Felipe García, Gabriel Mestre, Montserrat Plana, Anna Cruceta, Alicia Capón, Teresa Gallart, José M. Miró, Tomàs Pumarola, José M. Gatell,
Tópico(s)HIV/AIDS Research and Interventions
ResumoThe objectives of this study were to determine the genotypic and phenotypic patterns of resistance in a group of early-stage antiretroviral-naive patients failing initial therapy with didanosine, stavudine and nevirapine. These patterns of resistance were determined at baseline and at time of virological failure in 89 antiretroviral-naive patients with CD4 cells >500 cells/ml and viral load >5000 copies/ml who received initial antiretroviral therapy with didanosine plus stavudine and nevirapine as part of the SCAN study, and who failed after having reached undetectable plasma levels ( 47.4- to 58.1-fold, delavirdine >74.4- to 168.9-fold and efavirenz >56.0- to 347.2-fold). Four of these seven patients also had thymidine analogue-associated mutations (TAM) (T215Y/F [2/4], M41L [1/4], D67N [2/4] and K70R [1/4]). Finally, one patient (7%) had exclusively TAM mutations (M41L). None of the patients developed mutations associated with didanosine resistance or phenotypic resistance to didanosine or stavudine. Suboptimal compliance or selection of nevirapine resistance often with TAM mutations was frequently associated with virological failure in a cohort of early-stage chronic HIV-1-infected patients treated with a protease inhibitor-sparing regimen.
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