[HIV-1 genotypic resistance profiles in children failing highly active antiretroviral therapy].
OBJECTIVE
To study the genotypic resistance profiles of HIV-1 children failing highly active antiretroviral therapy (HAART) so as to provide helpful information for the treatment regime of Chinese children infected with HIV-1.


METHODS
Peripheral venous blood samples were collected from 20 HIV-1 infected children of Henan province, aged 9 (3 - 14). Nested RT-PCR was used to amplify part of the RT (40 -250 aa) gene. The PCR products of RT gene underwent nucleotide sequencing, the resulting nucleotide sequences were analyzed by the HIVdb data offered by the Stanford University web site to find the drug resistance mutations.


RESULTS
(1) Phylogenetic analysis revealed that 20 of the RT sequences were classified as subtype B. (2) According to the genotypic analysis, 20 , 15, and 13 children showed high level resistance to the nevirapine. (NVP), delavirdine (DLV), and efavirenz (EFV) respectively; 7 and 5 children showed high and intermediate level resistance to azidothymidine (AZT) respectively. Five children showed potential low-level and intermediate level resistance to lamivudine (3TC), and 11 showed high level resistance to 3TC; 11 showed intermediate and high level resistance to stavudine (d4T) and didanoside (ddI) respectively; and 19 and 12 children showed resistance to abacavir (ABC) and tenofovir (TDF) which had never been taken by these children.


CONCLUSIONS
The emergence of HIV resistant strains during antiretroviral therapy is one of the main reasons for treatment failure in HIV-infected children.
Liu
Zhi-Ying
ZY
National Center for AIDS/STD Prevention & Control, Chinese CDC, Beijing 100050, China.
Wei
Hong-Shan
HS
Zhao
Hong-Xin
HX
Liu
Ya-Nan
YN
Zhao
Yan
Y
Han
Ning
N
Cheng
Jun
J
Zhang
Fu-Jie
FJ
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000821:virology; D000293:Adolescent; D000480:Alkynes; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D048588:Benzoxazines / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002681:China; D003521:Cyclopropanes; D020008:Delavirdine / Q000494:pharmacology / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000235:genetics; D005838:Genotype; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D009154:Mutation; D019829:Nevirapine / Q000494:pharmacology / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D019562:Viral Load; D015215:Zidovudine / Q000494:pharmacology / Q000627:therapeutic use
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D015215:Zidovudine; D019829:Nevirapine; D020008:Delavirdine; C098320:efavirenz