title: Analysis of HIV- type 1 protease and reverse transcriptase in Brazilian children failing highly active antiretroviral therapy (HAART).
abstract: The aim of this study was to evaluate the genotypic resistance profiles of HIV-1 in children failing highly active antiretroviral therapy (HAART). Forty-one children (median age = 67 months) receiving HAART were submitted to genotypic testing when virological failure was detected. cDNA was extracted from PBMCs and amplified by nested PCR for the reverse transcriptase and protease regions of the pol gene. Drug resistance genotypes were determined from DNA sequencing. According to the genotypic analysis, 12/36 (33.3%) and 6/36 (16.6%) children showed resistance and possible resistance, respectively, to ZDV; 5/36 (14%) and 4/36 (11.1%), respectively, showed resistance and possible resistance to ddI; 4/36 (11.1%) showed resistance to 3TC and D4T; and 3/36 (8.3%) showed resistance to Abacavir. A high percentage (54%) of children exhibited mutations conferring resistance to NNRTI class drugs. Respective rates of resistance and possible resistance to PIs were: RTV (12.2%, 7.3%); APV (2.4%, 12.1%); SQV(0%, 12.1%); IDV (14.6%, 4.9%), NFV (22%, 4.9%), LPV/RTV (2.4%, 12.1%). Overall, 37/41 (90%) children exhibited virus with mutations related to drug resistance, while 9% exhibited resistance to all three antiretroviral drug classes.
authors.affiliation: Instituto de Medicina Tropical de São Paulo, LIMHC-USP, São Paulo, SP, Brazil. dm.machado@uol.com.br
authors.forename: Daisy Maria
authors.initials: DM
authors.lastname: Machado
authors.forename: Silvana Cláudia
authors.initials: SC
authors.lastname: Fernandes
authors.forename: Regina Célia de Menezes
authors.initials: RC
authors.lastname: Succi
authors.forename: Wilton Santos
authors.initials: WS
authors.lastname: Freire
authors.forename: Cláudio Sérgio
authors.initials: CS
authors.lastname: Pannuti
authors.forename: Aída Barbosa
authors.initials: AB
authors.lastname: Gouveia
authors.forename: José Eduardo
authors.initials: JE
authors.lastname: Levi
authors.forename: Ricardo Sobie
authors.initials: RS
authors.lastname: Diaz
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D024882:Drug Resistance, Viral / Q000235:genetics*; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D016333:HIV Protease / Q000235:genetics*; D054303:HIV Reverse Transcriptase / Q000235:genetics*; D015497:HIV-1 / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D006801:Humans; D007223:Infant; D009154:Mutation; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000235:genetics; D017211:Treatment Failure; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D054303:HIV Reverse Transcriptase; D016333:HIV Protease