Prevalence of drug resistance and newly recognised treatment-related substitutions in the HIV-1 reverse transcriptase and protease genes from HIV-positive patients naïve for anti-retrovirals

• DOI: 10.1111/j.1469-0691.2004.00938.x
• Publication Date: 2004-09-03T10:46:58Z
• Authors: C. Torti; L. Bono; F. Gargiulo; M.C. Uccelli; E. Quiros-Roldan; A. Patroni; G. Paraninfo; V. Tirelli; N. Manca; M.A. De Francesco; F. Perandin; G. Carosi
• Keywords: Microbiology (medical); Adult; Male; 0301 basic medicine; Anti-HIV Agents; HIV Infections; 03 medical and health sciences; HIV Protease; Drug Resistance, Viral; Prevalence; Humans; 0303 health sciences; HIV; anti-retroviral therapy; General Medicine; HIV Protease Inhibitors; Middle Aged; HIV Reverse Transcriptase; 3. Good health; AIDS; Infectious Diseases; resistance mutations; Mutation; HIV-1; Reverse Transcriptase Inhibitors; Female

The aim of this study was to assess the prevalence of genetic changes in either the HIV reverse transcriptase (RT) or protease (Pro) genes in a cohort of patients naïve for anti-retroviral therapy. Of 61 patients, 43 (70.5%) were infected with HIV strains harbouring at least one resistance-related mutation, with 41 (67.2%) harbouring newly recognised treatment-related mutations. Among the 61 patients, the prevalence of specific mutations in the RT gene was as follows: 39A, 1.6%; 43E, 1.6%; and 228H, 1.6%. The prevalence of specific mutations in the Pro gene was as follows: 11I, 1.6%; 13V, 26.2%; 35D, 19.6%; 45R, 1.6%; 58E, 1.6%; 62V, 31%; 72V, 11.4%; 72M, 6.5%; 72T, 3.2%; 75I, 1.6%; and 89M, 13%. A higher prevalence of newly recognised mutations was found in strains from patients infected through sexual practices (30/36 = 83.4% vs. 11/25 = 44%; p 0.0023; OR 10.91; 95% CI 3.14-40.39). These findings support the use of resistance testing in patients naïve for anti-retroviral therapy, and suggest that the possible impact of newly recognised treatment-related mutations on clinical outcome requires further investigation.