title: Mutations selected in HIV-2-infected patients failing a regimen including atazanavir.
abstract: OBJECTIVE
  To investigate mutations selected in viruses from HIV-2-infected patients failing a highly active antiretroviral treatment (HAART) regimen including atazanavir/ritonavir.
  
  
  METHODS
  Twenty-eight HIV-2-infected patients previously exposed to atazanavir/ritonavir and failing therapy were studied. The protease (PR) gene was amplified and sequenced, and mutations emerging under atazanavir/ritonavir selective pressure were reported.
  
  
  RESULTS
  The I50L mutation emerged in 4 out of 28 HIV-2-infected patients failing a HAART regimen including atazanavir/ritonavir. Besides I50L, four PR mutations previously associated with protease inhibitor resistance (I54L, I64V, V71I and I82F) and six PR mutations of unknown impact (V10I, E37D, S43T, K45R, I75V and F85L) in HIV-2 were also identified in this small group of patients.
  
  
  CONCLUSIONS
  Several mutations were associated with virological failure of a regimen including atazanavir/ritonavir in HIV-2-infected patients, including I50L for the first time. It should be included in HIV-2 algorithms for interpretation of genotypic resistance data, and taken into account when making therapeutic decisions for HIV-2-infected patients.
authors.affiliation: Centro de Malária e Outras Doenças Tropicais, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal. jo.cvsilva@gmail.com
authors.forename: Joana
authors.initials: J
authors.lastname: Cavaco-Silva
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Aleixo
authors.forename: Kristel
authors.initials: K
authors.lastname: Van Laethem
authors.forename: Domitília
authors.initials: D
authors.lastname: Faria
authors.forename: Emília
authors.initials: E
authors.lastname: Valadas
authors.forename: Maria de Fátima
authors.initials: Mde F
authors.lastname: Gonçalves
authors.forename: Perpétua
authors.initials: P
authors.lastname: Gomes
authors.forename: Anne-Mieke
authors.initials: AM
authors.lastname: Vandamme
authors.forename: Celso
authors.initials: C
authors.lastname: Cunha
authors.forename: Ricardo Jorge
authors.initials: RJ
authors.lastname: Camacho
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D000069446:Atazanavir Sulfate; D015658:HIV Infections / Q000188:drug therapy* / Q000235:genetics*; D015498:HIV-2 / Q000235:genetics*; D006801:Humans; D009154:Mutation / Q000235:genetics*; D009842:Oligopeptides / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D019438:Ritonavir / Q000627:therapeutic use; D017211:Treatment Failure
chemical_list: D019380:Anti-HIV Agents; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate; D019438:Ritonavir