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Protease Inhibitor Resistance Is Uncommon in HIV-1 Subtype C Infected Patients on Failing Second-Line Lopinavir/r-Containing Antiretroviral Therapy in South Africa.

Wallis CL, Mellors JW, Venter WD, Sanne I, Stevens W - AIDS Res Treat (2010)

Bottom Line: Limited data exist on HIV-1 drug resistance patterns in South Africa following second-line protease-inhibitor containing regimen failure.Ninety six percent of patients (n = 72) were infected with HIV-1 subtype C, two patients were infected with HIV-1 subtype D and one with HIV-1 subtype A1.Thirty nine percent (n = 29) of patients had no resistance mutations in protease or reverse transcriptase suggesting that medication non-adherence was a major factor contributing to failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular Medicine & Hematology, University of the Witwatersrand, Wits Medical School, 3B22, 3rd Floor, 7 York Road, Parktown 2193, South Africa.

ABSTRACT
Limited data exist on HIV-1 drug resistance patterns in South Africa following second-line protease-inhibitor containing regimen failure. This study examined drug resistance patterns emerging in 75 HIV-1 infected adults experiencing virologic failure on a second-line regimen containing 2 NRTI and lopinavir/ritonavir. Ninety six percent of patients (n = 72) were infected with HIV-1 subtype C, two patients were infected with HIV-1 subtype D and one with HIV-1 subtype A1. Thirty nine percent (n = 29) of patients had no resistance mutations in protease or reverse transcriptase suggesting that medication non-adherence was a major factor contributing to failure. Major lopinavir resistance mutations were infrequent (5 of 75; 7%), indicating that drug resistance is not the main barrier to future viral suppression.

No MeSH data available.


Related in: MedlinePlus

Frequency of mutations occurring in the RT region of patients failing second-line therapy. Light gray bars indicate thymidine analog mutations (TAMs), dark gray bars other NRTIs mutations, and black bars NNRTIs mutations.
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fig2: Frequency of mutations occurring in the RT region of patients failing second-line therapy. Light gray bars indicate thymidine analog mutations (TAMs), dark gray bars other NRTIs mutations, and black bars NNRTIs mutations.

Mentions: Forty-one (55%) patients had mutations in the RT region only. Nineteen had mutations conferring resistance to NNRTI alone, and 22 had resistance to both NRTI and NNRTI. The most common NNRTI mutations observed were K103N (n = 16; 21%) and V106M (n = 9; 12%; Figure 2). Thirteen of the 75 patients (17%) had NNRTI resistance mutations associated with reduced susceptibility to etravirine, but only 2 of the 13 had a weighting score of greater than 2.5 predictive of a poor virologic response to etravirine. Of the 30 patients with NRTI resistance mutations, 15 had the M184V mutation, 10 had TAMs (Table 1), 1 had Q151M complex, and none had K65R. Eight percent (n = 6) of all patients had two or more TAMs or other resistance mutations that would cause broad NRTI cross-resistance (Q151M).


Protease Inhibitor Resistance Is Uncommon in HIV-1 Subtype C Infected Patients on Failing Second-Line Lopinavir/r-Containing Antiretroviral Therapy in South Africa.

Wallis CL, Mellors JW, Venter WD, Sanne I, Stevens W - AIDS Res Treat (2010)

Frequency of mutations occurring in the RT region of patients failing second-line therapy. Light gray bars indicate thymidine analog mutations (TAMs), dark gray bars other NRTIs mutations, and black bars NNRTIs mutations.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3066558&req=5

fig2: Frequency of mutations occurring in the RT region of patients failing second-line therapy. Light gray bars indicate thymidine analog mutations (TAMs), dark gray bars other NRTIs mutations, and black bars NNRTIs mutations.
Mentions: Forty-one (55%) patients had mutations in the RT region only. Nineteen had mutations conferring resistance to NNRTI alone, and 22 had resistance to both NRTI and NNRTI. The most common NNRTI mutations observed were K103N (n = 16; 21%) and V106M (n = 9; 12%; Figure 2). Thirteen of the 75 patients (17%) had NNRTI resistance mutations associated with reduced susceptibility to etravirine, but only 2 of the 13 had a weighting score of greater than 2.5 predictive of a poor virologic response to etravirine. Of the 30 patients with NRTI resistance mutations, 15 had the M184V mutation, 10 had TAMs (Table 1), 1 had Q151M complex, and none had K65R. Eight percent (n = 6) of all patients had two or more TAMs or other resistance mutations that would cause broad NRTI cross-resistance (Q151M).

Bottom Line: Limited data exist on HIV-1 drug resistance patterns in South Africa following second-line protease-inhibitor containing regimen failure.Ninety six percent of patients (n = 72) were infected with HIV-1 subtype C, two patients were infected with HIV-1 subtype D and one with HIV-1 subtype A1.Thirty nine percent (n = 29) of patients had no resistance mutations in protease or reverse transcriptase suggesting that medication non-adherence was a major factor contributing to failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular Medicine & Hematology, University of the Witwatersrand, Wits Medical School, 3B22, 3rd Floor, 7 York Road, Parktown 2193, South Africa.

ABSTRACT
Limited data exist on HIV-1 drug resistance patterns in South Africa following second-line protease-inhibitor containing regimen failure. This study examined drug resistance patterns emerging in 75 HIV-1 infected adults experiencing virologic failure on a second-line regimen containing 2 NRTI and lopinavir/ritonavir. Ninety six percent of patients (n = 72) were infected with HIV-1 subtype C, two patients were infected with HIV-1 subtype D and one with HIV-1 subtype A1. Thirty nine percent (n = 29) of patients had no resistance mutations in protease or reverse transcriptase suggesting that medication non-adherence was a major factor contributing to failure. Major lopinavir resistance mutations were infrequent (5 of 75; 7%), indicating that drug resistance is not the main barrier to future viral suppression.

No MeSH data available.


Related in: MedlinePlus