title: Correlation between antiretroviral resistance mutations, biological parameters, and clinical evolution in zidovudine-treated patients infected with human immunodeficiency virus type 1.
abstract: To evaluate the correlation between zidovudine (ZDV) resistance mutations of human immunodeficiency virus type 1 (HIV-1), biological parameters, and clinical evolution, 111 HIV-1-infected patients treated with ZDV were studied. Specific mutations at codons 70, 215, and 41 in the HIV-1 reverse transcriptase coding region conferring resistance to ZDV were detected using a selective polymerase chain reaction. The appearance of ZDV resistance mutations was significantly correlated with baseline clinical stage, CD4+ cell count, and viral load, but not with duration of ZDV therapy or p24 antigen level. In univariate analysis, results showed a prognostic role of mutations at codons 215 and 41 for clinical progression to the acquired immune deficiency syndrome (AIDS) or death. In multivariate analysis after controlling for viral load, CD4+ cell count, and clinical stage, the presence of the mutation at codon 215 (but not at codon 41) remained an independent predictor of subsequent clinical evolution.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 271, Lyon, France.
authors.forename: K
authors.initials: K
authors.lastname: Leriche-Guérin
authors.forename: M A
authors.initials: MA
authors.lastname: Trabaud
authors.forename: L
authors.initials: L
authors.lastname: Cotte
authors.forename: F
authors.initials: F
authors.lastname: Bissuel
authors.forename: E
authors.initials: E
authors.lastname: Deruelle
authors.forename: P
authors.initials: P
authors.lastname: Rougier
authors.forename: C
authors.initials: C
authors.lastname: Trépo
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D004351:Drug Resistance / Q000235:genetics; D005260:Female; D016655:HIV Core Protein p24 / Q000032:analysis / Q000276:immunology; D015658:HIV Infections / Q000188:drug therapy* / Q000235:genetics / Q000821:virology; D054303:HIV Reverse Transcriptase / Q000235:genetics* / Q000276:immunology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D009154:Mutation; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D016655:HIV Core Protein p24; D012367:RNA, Viral; D015215:Zidovudine; D054303:HIV Reverse Transcriptase