title: Predictors for the emergence of the 2 multi-nucleoside/nucleotide resistance mutations 69 insertion and Q151M and their impact on clinical outcome in the Swiss HIV cohort study.
abstract: The 69 insertion and Q151M mutations are multi-nucleoside/nucleotide resistance mutations (MNR). The prevalence among 4078 antiretroviral therapy (ART)-experienced individuals was <1.3%. Combined ART fully prevented MNR in subtype B infections. Case-control studies were performed to identify risk factors. Control subjects were patients with ≥ 3 thymidine-analogue mutations. The 69 insertion study (27 control subjects, 14 case patients) identified didanosine exposure as a risk (odds ratio, 5.0 per year; P = .019), whereas the Q151M study (which included 44 control subjects and 25 case patients) detected no associations. Following detection, individuals with Q151M tended to have lower suppression rates and higher mortality rates, relative to control subjects. Additional studies are needed to verify these findings in non-subtype B infections.
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zürich, Switzerland. alexandra.scherrer@usz.ch
authors.forename: Alexandra U
authors.initials: AU
authors.lastname: Scherrer
authors.forename: Viktor
authors.initials: V
authors.lastname: von Wyl
authors.forename: Beda
authors.initials: B
authors.lastname: Joos
authors.forename: Thomas
authors.initials: T
authors.lastname: Klimkait
authors.forename: Philippe
authors.initials: P
authors.lastname: Bürgisser
authors.forename: Sabine
authors.initials: S
authors.lastname: Yerly
authors.forename: Jürg
authors.initials: J
authors.lastname: Böni
authors.forename: Bruno
authors.initials: B
authors.lastname: Ledergerber
authors.forename: Huldrych F
authors.initials: HF
authors.lastname: Günthard
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology; D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D016022:Case-Control Studies; D002423:Cause of Death; D015331:Cohort Studies; D016049:Didanosine / Q000494:pharmacology; D024921:Drug Resistance, Multiple, Viral / Q000235:genetics*; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D016015:Logistic Models; D009154:Mutation; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents; D016049:Didanosine