title: Prevalence of the HIV-1 protease mutation I47A in clinical practice and association with lopinavir resistance.
abstract: Mutation proI47A has recently been associated with lopinavir/ritonavir (LPV/r) resistance. Only four out of 1859 specimens (0.2%) sent for drug resistance testing (219 drug-naive and 1650 antiretroviral-experienced) showed I47A. All belonged to patients failing LPV/r. The prevalence among protease inhibitor-experienced patients was 0.6%. Phenotypic testing showed that proI47A caused high-level lopinavir resistance (> 100-fold) and cross-resistance to amprenavir, whereas it caused hypersusceptibility to saquinavir. ProI47A should thus be considered the primary lopinavir resistance mutation.
authors.affiliation: Service of Infectious Diseases, Hospital Carlos III, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: de Mendoza
authors.forename: Luisa
authors.initials: L
authors.lastname: Valer
authors.forename: Lee
authors.initials: L
authors.lastname: Bacheler
authors.forename: Theresa
authors.initials: T
authors.lastname: Pattery
authors.forename: Angélica
authors.initials: A
authors.lastname: Corral
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
mesh_terms: D002219:Carbamates / Q000627:therapeutic use; D003062:Codon / Q000235:genetics; D024882:Drug Resistance, Viral / Q000235:genetics; D005663:Furans; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000235:genetics*; D017320:HIV Protease Inhibitors / Q000097:blood / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D019469:Indinavir / Q000627:therapeutic use; D061466:Lopinavir; D009154:Mutation; D019888:Nelfinavir / Q000627:therapeutic use; D010641:Phenotype; D011744:Pyrimidinones / Q000097:blood / Q000627:therapeutic use*; D019438:Ritonavir / Q000627:therapeutic use; D019258:Saquinavir / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D002219:Carbamates; D003062:Codon; D005663:Furans; D017320:HIV Protease Inhibitors; D011744:Pyrimidinones; D013449:Sulfonamides; D061466:Lopinavir; C095108:amprenavir; D019469:Indinavir; D019888:Nelfinavir; D019258:Saquinavir; D019438:Ritonavir