Impact of human immunodeficiency virus type 1 subtypes on virologic response and emergence of drug resistance among children in the Paediatric European Network for Treatment of AIDS (PENTA) 5 trial.
The association between virologic response and human immunodeficiency virus type 1 (HIV-1) subtype was investigated in 113 HIV-1-infected children randomly assigned to receive zidovudine plus lamivudine, zidovudine plus abacavir, or lamivudine plus abacavir in the Paediatric European Network for Treatment of AIDS (PENTA) 5 trial. Symptomatic children (n=68) also received nelfinavir; asymptomatic children (n=45) were randomly assigned to receive nelfinavir or placebo. HIV-1 subtypes A, B, C, D, F, G, H, A/E, and A/G were found in 15%, 41%, 16%, 9%, 5%, 2%, 1%, 5%, and 7% of the children, respectively. Resistance assay failure rates were higher for non-B subtypes than for B subtypes (genotype, P=.01; phenotype, P=.02). HIV-1 subtype was not associated with virologic response at 24 and 48 weeks after initiation of treatment. No differences were observed in the frequency of development of resistance mutations L90M (P=1.00) and D30N (P=.61) in B and non-B viruses. In conclusion, no evidence that subtype determined virologic response to therapy was found.
Public Health Laboratory Service Antiviral Susceptibility Reference Unit, Birmingham Public Health Laboratory, Birmingham, United Kingdom.
Deenan
D
Pillay
A Sarah
AS
Walker
Diana M
DM
Gibb
Anita
A
de Rossi
Steve
S
Kaye
Mounir
M
Ait-Khaled
Maria
M
Muñoz-Fernandez
Abdel
A
Babiker
D000998:Antiviral Agents / Q000378:metabolism / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism / Q000821:virology; D017320:HIV Protease Inhibitors / Q000378:metabolism / Q000627:therapeutic use*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics / Q000378:metabolism; D006801:Humans; D019888:Nelfinavir / Q000378:metabolism / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000378:metabolism / Q000627:therapeutic use*
D000998:Antiviral Agents; D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D019888:Nelfinavir