[Genotypic resistance to antiretroviral drugs in patients with therapeutic failure to highly active antiretroviral therapy].
BACKGROUND
To assess genotypic resistance mutations in patients with virological failure with highly active antiretroviral therapy (HAART) METHODS: Genotyping of reverse transcriptase (RT) and protease (PRO) HIV-1 genes were carried out in 33 adherent patients failing on HAART.


RESULTS
Resistance mutations were found in 32 of the 33; 27 of them (81.8%) being primary mutations: 26 (78.8%) in the RT gene and 60 (60.6%) in the PRO gene. Overall, 66.6% had genotypic resistance to two drugs and 60.6% showed resistance to drugs belonging to the two main classes of antiretroviral drugs. At the time of treatment failure, 72.7% had on their therapeutic regimen one antiretroviral drug to which they had resistance mutations, 48.5% had genotypic resistance to two drugs of the therapeutic regimen and 21.2% to three drugs.


CONCLUSIONS
Most adherent patients failing on HAART carry drug resistant genotypes. These patients may constitute a reservoir of multidrug resistant HIV that may limit treatment options in the future.
Gutiérrez
F
F
Unidad de Enfermedades Infecciosas. Servicio de Medicina Interna. Hospital General Universitario de Elche. Departamento de Medicina. Universidad Miguel Hernández. Alicante. fgutierrezr@medynet.com
Moltó
J
J
Escolano
C
C
Mora
A
A
Pasquau
F
F
Gregori
J
J
Nogueira
E
E
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000494:pharmacology*; D023241:Antiretroviral Therapy, Highly Active; D004352:Drug Resistance, Microbial / Q000235:genetics*; D010450:Endopeptidases / Q000235:genetics; D005260:Female; D005838:Genotype; D006678:HIV / Q000187:drug effects* / Q000235:genetics*; D015658:HIV Infections / Q000188:drug therapy* / Q000235:genetics / Q000821:virology; D017320:HIV Protease Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D019469:Indinavir / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009154:Mutation; D019829:Nevirapine / Q000494:pharmacology / Q000627:therapeutic use; D011480:Protease Inhibitors / Q000494:pharmacology; D012194:RNA-Directed DNA Polymerase / Q000235:genetics; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D017211:Treatment Failure; D015215:Zidovudine / Q000494:pharmacology / Q000627:therapeutic use
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D011480:Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine; D019469:Indinavir; D019829:Nevirapine; D012194:RNA-Directed DNA Polymerase; D010450:Endopeptidases