Long-term analysis of the resistance development in HIV-1 positive patients treated with protease and reverse transcriptase inhibitors: correlation of the genotype and disease progression
Language English Country Switzerland Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
15929396
Knihovny.cz E-resources
- MeSH
- Genotype MeSH
- HIV Infections drug therapy virology MeSH
- HIV Reverse Transcriptase genetics MeSH
- HIV-1 drug effects genetics isolation & purification MeSH
- HIV Protease genetics MeSH
- HIV Protease Inhibitors administration & dosage therapeutic use MeSH
- Reverse Transcriptase Inhibitors administration & dosage therapeutic use MeSH
- Anti-HIV Agents administration & dosage therapeutic use MeSH
- Humans MeSH
- Mutation MeSH
- CD4 Lymphocyte Count MeSH
- Reverse Transcriptase Polymerase Chain Reaction MeSH
- Disease Progression MeSH
- RNA, Viral genetics MeSH
- Amino Acid Substitution MeSH
- Drug Resistance, Viral genetics MeSH
- Viral Load MeSH
- Antiretroviral Therapy, Highly Active MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
- Names of Substances
- HIV Reverse Transcriptase MeSH
- HIV Protease MeSH
- HIV Protease Inhibitors MeSH
- Reverse Transcriptase Inhibitors MeSH
- Anti-HIV Agents MeSH
- RNA, Viral MeSH
In this study, 27 HIV-1-positive patients on long-term highly active antiretroviral therapy (HAART) in the Czech Republic were followed for a period of up to 7 years. Variability of the HIV-1 protease (PR) sequence common in the Czech Republic was observed. Under the pressure of inhibitors of protease (PRIs) and reverse transcriptase (RTIs) mutations in PR were detected. Development of resistance to PRIs was followed by a decrease in CD4 count and increase in viral load. The dynamics of viral load closely corresponded to the accumulation of specific primary mutations in PR and RT. Out of 27 patients 18 developed resistance to PRIs and the prolonged therapy led to the accumulation of a higher number of amino acid changes associated with the resistance and, consequently, cross-resistance to several PRIs was observed. These multi-resistant variants of HIV-1 with mutations in PR could not be inhibited sufficiently with PRIs that are currently available in clinical practice. Efficient yet temporary suppression of viral replication was achieved by a lopinavir (LPV) treatment.
