Antiretroviral genotypic resistance mutations in HIV-1 infected Korean patients with virologic failure.
Resistance assays are useful in guiding decisions for patients experiencing virologic failure (VF) during highly-active antiretroviral therapy (HAART). We investigated antiretroviral resistance mutations in 41 Korean human immunodeficiency virus type 1 (HIV-1) infected patients with VF and observed immunologic/virologic response 6 months after HAART regimen change. Mean HAART duration prior to resistance assay was 45.3+/-27.5 months and commonly prescribed HAART regimens were zidovudine/lamivudine/nelfinavir (22.0%) and zidovudine/lamivudine/efavirenz (19.5%). Forty patients (97.6%) revealed intermediate to high-level resistance to equal or more than 2 antiretroviral drugs among prescribed HAART regimen. M184V/I mutation was observed in 36 patients (87.7%) followed by T215Y/F (41.5%) and M46I/L (34%). Six months after resistance assay and HAART regimen change, median CD4+ T cell count increased from 168 cells/microL (interquartile range [IQR], 62-253) to 276 cells/microL (IQR, 153-381) and log viral load decreased from 4.65 copies/mL (IQR, 4.18-5.00) to 1.91 copies/mL (IQR, 1.10-3.60) (P<0.001 for both values). The number of patients who accomplished viral load <400 copies/mL was 26 (63.4%) at 6 months follow-up. In conclusion, many Korean HIV-1 infected patients with VF are harboring strains with multiple resistance mutations and immunologic/virologic parameters are improved significantly after genotypic resistance assay and HAART regimen change.
Chin
Bum Sik
BS
Division of AIDS, Center for Immunology and Pathology, Korea National Institute of Health, Seoul, Korea.
Choi
Ju-Yeon
JY
Choi
Jin Young
JY
Kim
Gab Jung
GJ
Kee
Mee-Kyung
MK
Kim
June Myung
JM
Kim
Sung Soon
SS
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D001681:Biological Assay / Q000379:methods / Q000706:statistics & numerical data; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000235:genetics; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult