title: [Evolution of HIV-1 drug resistance in patients failing combination antiretroviral therapy].
abstract: OBJECTIVE
  This study aimed to evolution of genotypic drug resistance prevalence in treatment-failing patients in Shenzhen.
  
  
  METHODS
  Peripheral venous blood samples were collected from 41 AIDS patients whom failing combination antiretroviral therapy, and were amplified by nested PCR; then the amplified fragments were sequenced and analyzed.
  
  
  RESULTS
  Partial pol sequences of 38 samples were successfully amplified, and 3 samples have not found any mutations in their pol sequences. K103N, G190A, Y181C, K101P, M184V, D67N, K70R, T215Y and K219 were most common mutations. According to the genotypic analysis, 100% of the patients (35/35) showed high and intermediate level resistance to nevirapine (NVP) and efavirenz (EFV); above 50% of the patients showed high and intermediate level resistance to zidovudine (AZT), lamivudine (3TC), stavudine (D4T) and didanosine (DDI); only a few patients showed intermediate and low level drug resistance to protease inhibitors (PIs). Patients whom take D4T + DDI + NVP regimens were most common to appear drug mutation.
  
  
  CONCLUSIONS
  The high prevalence of drug resistance to NNRTIs and NRTIs among patients failing combination antiretroviral therapy in Shenzhen. That is the main reason for treatment failure in AIDS patients. Now most of mutations were detected against NNRTIs and NRTIs, only a few against PIs. Our finding suggested that a second-line antiretroviral therapy regimens is needed among the patients failing therapy and the boosted-PIs maybe are good choice.
authors.affiliation: Shenzhen the Third People's Hospital, Shenzhen 518020, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Hong-mei
authors.initials: HM
authors.lastname: Zhang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Jiang
authors.forename: Qiao-li
authors.initials: QL
authors.lastname: Peng
authors.forename: Yan
authors.initials: Y
authors.lastname: Tan
authors.forename: Tai-sheng
authors.initials: TS
authors.lastname: Li
authors.forename: Bo-ping
authors.initials: BP
authors.lastname: Zhou
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000821:virology*; D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000235:genetics*; D019143:Evolution, Molecular; D005260:Female; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012367:RNA, Viral; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral