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Impact of the number of failed therapeutic regimes on the development of resistance mutations to HIV-1 in northeast Brazil
Medeiros, Melissa Soares; Arruda, Érico Antônio Gomes; Guerrant, Richard Littleton; Brown, Christopher Cooley; Lima, Aldo Ângelo Moreira.
  • Medeiros, Melissa Soares; Federal University of Ceará. IBIMED. Department of Pharmacology and Fisiology. Fortaleza. BR
  • Arruda, Érico Antônio Gomes; São José Infectious Diseases Hospital. Fortaleza. BR
  • Guerrant, Richard Littleton; University of Virginia. Center of Global Health. Charlottesville. US
  • Brown, Christopher Cooley; University of Virginia. Center of Global Health. Charlottesville. US
  • Lima, Aldo Ângelo Moreira; Federal University of Ceará. IBIMED. Department of Pharmacology and Fisiology. Fortaleza. BR
Braz. j. infect. dis ; 11(5): 451-455, Oct. 2007. graf, tab
Artigo em Inglês | LILACS | ID: lil-465766
ABSTRACT
Highly-potent antiretroviral therapy is necessary to avoid viral replication in HIV patients; however, it can favor the appearance of resistance mutations. The mutations 41L, 67N, 70R, 210W, 215Y/F, 219E/Q, 44D and 118I are defined as nucleoside analogous mutations (NAMs), because they affect the efficacy of all nucleoside reverse transcriptase inhibitors (NRTI). The mutation most frequently associated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) is 103N. 33W/F, 82A/F/L/T, 84V and 90M are called protease inhibitor resistance-associated mutations (PRAM), because they are associated with resistance to several protease inhibitors (PI). This study evaluated the development of resistance mutations and examine the susceptibility of HIV with these mutations to antiretrovirals in HIV-1 patients who have failed one or more therapy regimes. Analyses were made of 101 genotypic tests of patients with therapeutic failure to 2 or 3-drug regimens with NRTI, NNRTI or PI. We used the Stanford database to define the susceptibility profile of the viruses. The samples were divided into three treatment-failure groups first (F), second (S) and multi-failure (MF) to antiretroviral regimens, and we correlated these groups with resistance profiles and principal mutations. There was a significant increase in resistance mutations V82A/F/L/T, I84V, L90M, M41L, K70R, L210W, T215Y/F and K219Q/E in MF. We also found significantly higher resistance to zidovudine, didanosine, stavudine and abacavir in MF. There was no increase in resistance to tenofovir (p=0.28) and lopinavir (p=0.079) in MF. A high degree of resistance to NNRTIs was observed in all groups. Increased resistance mutations will affect future therapeutic options for HIV patients in Brazil because it results in a significant increase in resistance to antiretroviral drugs.
Assuntos

Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Infecções por HIV / HIV-1 / Fármacos Anti-HIV / Farmacorresistência Viral Múltipla / Transcriptase Reversa do HIV Tipo de estudo: Estudo observacional / Fatores de risco Limite: Humanos País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Braz. j. infect. dis Assunto da revista: Doenças Transmissíveis Ano de publicação: 2007 Tipo de documento: Artigo País de afiliação: Brasil / Estados Unidos Instituição/País de afiliação: Federal University of Ceará/BR / São José Infectious Diseases Hospital/BR / University of Virginia/US

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Infecções por HIV / HIV-1 / Fármacos Anti-HIV / Farmacorresistência Viral Múltipla / Transcriptase Reversa do HIV Tipo de estudo: Estudo observacional / Fatores de risco Limite: Humanos País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Braz. j. infect. dis Assunto da revista: Doenças Transmissíveis Ano de publicação: 2007 Tipo de documento: Artigo País de afiliação: Brasil / Estados Unidos Instituição/País de afiliação: Federal University of Ceará/BR / São José Infectious Diseases Hospital/BR / University of Virginia/US