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Microbiol Immunol ; 47(7): 499-505, 2003.
Article in English | MEDLINE | ID: mdl-12953843

ABSTRACT

In the present study, we performed genotypic drug-resistance testing in 116 therapy-naive human immunodeficiency virus type 1 (HIV-1)-infected patients between 1999 and 2002 at Nagoya National Hospital, Japan. The prevalence of drug-resistant HIV-1 with one or more major mutations significantly increased from 5.3% (4/75) in 1999-2001 to 17.1% (7/41) in 2002 (P=0.05), suggesting the spread of drug-resistant HIV-1. We identified a patient who possessed a protease (PR) inhibitor-resistant HIV-1 with a major mutation consisting of L90M before the initiation of therapy. The patient was administered zidovudine, lamivudine, and efavirenz as highly active antiretroviral therapy (HAART), as PR inhibitors were excluded based on the result of the drug-resistance testing. The treatment succeeded in strongly suppressing the proliferation of drug-resistant HIV-1 and concomitantly increased CD4 cell counts. Thus, we conclude that drug-resistance testing prior to the initiation of therapy is important for therapy-naive patients to devise the optimum therapy regimen for each individual.


Subject(s)
Anti-HIV Agents/pharmacology , Drug Resistance, Viral/genetics , HIV Infections/epidemiology , HIV Infections/virology , HIV-1/drug effects , Adult , Aged , Anti-HIV Agents/therapeutic use , CD4 Lymphocyte Count , Female , Genotype , HIV Envelope Protein gp120/chemistry , HIV Envelope Protein gp120/genetics , HIV Infections/drug therapy , HIV Protease/chemistry , HIV Protease/genetics , HIV Protease Inhibitors/pharmacology , HIV Reverse Transcriptase/chemistry , HIV Reverse Transcriptase/genetics , HIV-1/genetics , HIV-1/isolation & purification , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Mutation , Peptide Fragments/chemistry , Peptide Fragments/genetics , Prevalence
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