title: Minor mutations in HIV protease at baseline and appearance of primary mutation 90M in patients for whom their first protease-inhibitor antiretroviral regimens failed.
abstract: The association between minor mutations in human immunodeficiency virus (HIV) protease at baseline and development of common primary mutation 90M at virological failure (conferring some resistance to all protease inhibitors [PIs]) was evaluated in 93 previously drug-naive patients experiencing failure of their first PI-based antiretroviral regimens. In logistic regression analysis, the probability of accumulating a new 90M mutation at virological failure was associated with the presence at baseline of minor mutation 36I (naturally occurring in approximately 25% of HIV clade B and in >80% of HIV non-clade-B viruses) (adjusted odds ratio, 13.5 [95% confidence interval, 1.89-95.6]; P=.009) and, possibly, of 10I/V. This suggests a potential role for the presence of 36I at baseline in predicting the appearance of 90M at virological failure.
authors.affiliation: Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, University of Rome Tor Vergata, Italy. cf.perno@uniroma2.it
authors.forename: Carlo Federico
authors.initials: CF
authors.lastname: Perno
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cozzi-Lepri
authors.forename: Federica
authors.initials: F
authors.lastname: Forbici
authors.forename: Ada
authors.initials: A
authors.lastname: Bertoli
authors.forename: Michela
authors.initials: M
authors.lastname: Violin
authors.forename: Maria
authors.initials: M
authors.lastname: Stella Mura
authors.forename: Giampiero
authors.initials: G
authors.lastname: Cadeo
authors.forename: Anna
authors.initials: A
authors.lastname: Orani
authors.forename: Antonio
authors.initials: A
authors.lastname: Chirianni
authors.forename: Carlo
authors.initials: C
authors.lastname: De Stefano
authors.forename: Claudia
authors.initials: C
authors.lastname: Balotta
authors.forename: Antonella
authors.initials: A
authors.lastname: d'Arminio Monforte
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D006678:HIV / Q000201:enzymology* / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D016333:HIV Protease / Q000235:genetics* / Q000378:metabolism; D017320:HIV Protease Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017354:Point Mutation; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA
chemical_list: D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D016333:HIV Protease