Long-term benefit of genotypic-guided therapy and prevalence of multinucleoside resistance in an Italian group of antiretroviral multiexperienced patients

Journal of Clinical Laboratory Analysis
Eugenia Quiros-RoldanGiampiero Carosi

Abstract

Multiple nucleoside resistance involves specific genetic changes in the HIV-1 reverse transcriptase gene, such as Q151M mutation and an insertion of two serine aminoacids at RT codon 69. Among 432 patients failing antiretroviral therapy, five (1.15%) harboured viruses with Q151M mutation into the RT gene and no viruses were identified harbouring insertion at codon 69. Also we have studied the long-term benefit of HIV genotypic testing with the failure to reach a viral load below 50 copies/ml within 1 year of antiretroviral therapy using as the primary end-point. A group of 64 HIV-positive antiretroviral multiexperienced patients were examined, all of them failing the current ART. HIV-RNA changed -0.8 log at month 4 and +0.1 log and -0.5 log at months 8 and 12, respectively. The proportion of patients with viral load below 50 copies/ml was 19.3, 32.8, and 28.1% at months 4, 8, and 12, respectively. In multidrug-experienced patients, genotype-guided therapy is not in fact able to achieve complete viral suppression in more than 30% of patients after 1 year of ART. The development of more precise resistance tests and interpretations are needed for better control of HIV replication. Other metabolic/pharmacokinetics factors of poor d...Continue Reading

References

Mar 14, 1995·Proceedings of the National Academy of Sciences of the United States of America·T ShirasakaR Yarchoan
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Jan 6, 1999·AIDS·G B Scott, R Tuomala

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Citations

May 25, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Elena LosinaRochelle P Walensky
Mar 11, 2003·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Francesco MazzottaUNKNOWN Genotipo-Fenotipo di Resistenza (GenPheRex) Group of the Italian Management Standardizzato di Terapia Antiretrovirale (MASTE

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