Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures
Autor(a) principal: | |
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Data de Publicação: | 2005 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/30950 |
Resumo: | INTRODUCTION: Information about HIV phenotypes of resistant to available ART and the influence of different risk factors on virological failures (VF) in Costa Rican HIV positive patients prior or during HAART is unknown. MATERIALS AND METHODS: Eighty nine samples, 72 VF and 17 basal (before treatment) were analyzed by examining resistant mutants in reverse transcriptase (RT) and protease (PT) regions using Trugene or LIPA genotyping kits. Sixty eight control patients were selected and relevant information was collected in a questionnaire. RESULTS: Poor adherence, presence of resistant mutations and number of treatment's changes were the only significant factors found (p = 0.006, 0.04 and 0.01 respectively). From 66 sequenced samples, 78%, 50% and 50% showed resistance to NRTI (nucleoside reverse transcriptase inhibitors), NNRT (non-nucleoside reverse transcriptase inhibitors) and PI (protease inhibitors), respectively. The most frequent mutations were M41L, M184V, and T215FY in RT and L62PI, L10FIRV and M36I in PT. DISCUSSION: The most important factor related to treatment response in this study was adherence to treatment. Mutations in RT were related to the treatment failure while the ones found in PT were secondary mutations which have been previously described to influence the selection of primary resistance mutations in these regions. The study reveals the urgency to detect resistant mutations in VF to be considered by physicians for selection of treatment schedule, to analyze basal HIV patients for monitoring of the spread of resistant mutations and the importance to reinforce the adherence in the patients for overall treatment outcome. |
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Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures Estudio de mutantes resistentes a los antiretrovirales en pacientes con VIH con falla terapeutica y efecto de los factores de riesgo en el tratamiento Human immunodeficiency virusAnti-retroviral treatmentResistance mutationsHighly active antiretroviral therapyRisk factorsResponseAdherence INTRODUCTION: Information about HIV phenotypes of resistant to available ART and the influence of different risk factors on virological failures (VF) in Costa Rican HIV positive patients prior or during HAART is unknown. MATERIALS AND METHODS: Eighty nine samples, 72 VF and 17 basal (before treatment) were analyzed by examining resistant mutants in reverse transcriptase (RT) and protease (PT) regions using Trugene or LIPA genotyping kits. Sixty eight control patients were selected and relevant information was collected in a questionnaire. RESULTS: Poor adherence, presence of resistant mutations and number of treatment's changes were the only significant factors found (p = 0.006, 0.04 and 0.01 respectively). From 66 sequenced samples, 78%, 50% and 50% showed resistance to NRTI (nucleoside reverse transcriptase inhibitors), NNRT (non-nucleoside reverse transcriptase inhibitors) and PI (protease inhibitors), respectively. The most frequent mutations were M41L, M184V, and T215FY in RT and L62PI, L10FIRV and M36I in PT. DISCUSSION: The most important factor related to treatment response in this study was adherence to treatment. Mutations in RT were related to the treatment failure while the ones found in PT were secondary mutations which have been previously described to influence the selection of primary resistance mutations in these regions. The study reveals the urgency to detect resistant mutations in VF to be considered by physicians for selection of treatment schedule, to analyze basal HIV patients for monitoring of the spread of resistant mutations and the importance to reinforce the adherence in the patients for overall treatment outcome. En Costa Rica no se tiene información a cerca de genotipos de resistencia para los tratamientos anti-retrovirales disponibles y la influencia de diferentes factores de riego en la falla virológica (FV) de pacientes VIH positivos previo o durante su tratamiento. Ochenta y nueve muestras, 72 FV y 17 basales, fueron analizadas con Trugene o LIPA para la detección de mutantes de resistencia en la transcriptasa reversa (TR) y en la proteasa (PT) del VIH. Se seleccionaron sesenta y ocho controles y se recolectó información relevante en un cuestionario. La mala adherencia, la presencia de mutaciones y el número de cambios de tratamiento fueron los únicos factores con significancia encontrados. (p = 0.03, 0.04 and 0.04 respectively). De 66 muestras secuenciadas, 78%, 50% y 50% mostraron resistencia a los inhibidores análogos y no análogos de nucleótidos para la TR y la PT respectivamente. La mutaciones más frecuentes fueron M41L, M184V, y T215FY en la TR y L62PI, L10FIRV y M36I en la PT. La adherencia fue el factor más importante relacionado con la respuesta al tratamiento. Las mutaciones encontradas en la TR estaban relacionadas al tratamiento mientras que las de la PT fueron mutaciones secundarias que propician la aparición de las mutaciones asociadas a resistencia en esa región. Este estudio revela la necesidad de detectar mutantes de resistencia en pacientes con FV y de estudiar las muestras basales. Además la importancia de reforzar la adherencia en los pacientes para una mejor respuesta al tratamiento. Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2005-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/30950Revista do Instituto de Medicina Tropical de São Paulo; Vol. 47 No. 6 (2005); 327-331 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 47 Núm. 6 (2005); 327-331 Revista do Instituto de Medicina Tropical de São Paulo; v. 47 n. 6 (2005); 327-331 1678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/30950/32834Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessTaylor-Castillo, LizethHerrera-Martínez, GiselaLeón-Bratti, María PazBoza, RicardoLeón-Rodríguez, BernalLuftig, Ronald B.Visoná, Kirsten2012-07-07T18:39:20Zoai:revistas.usp.br:article/30950Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:51:40.308939Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures Estudio de mutantes resistentes a los antiretrovirales en pacientes con VIH con falla terapeutica y efecto de los factores de riesgo en el tratamiento |
title |
Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures |
spellingShingle |
Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures Taylor-Castillo, Lizeth Human immunodeficiency virus Anti-retroviral treatment Resistance mutations Highly active antiretroviral therapy Risk factors Response Adherence |
title_short |
Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures |
title_full |
Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures |
title_fullStr |
Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures |
title_full_unstemmed |
Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures |
title_sort |
Study of antiretroviral mutants in HIV patients with treatment failures and the effect of risk factors in the virological failures |
author |
Taylor-Castillo, Lizeth |
author_facet |
Taylor-Castillo, Lizeth Herrera-Martínez, Gisela León-Bratti, María Paz Boza, Ricardo León-Rodríguez, Bernal Luftig, Ronald B. Visoná, Kirsten |
author_role |
author |
author2 |
Herrera-Martínez, Gisela León-Bratti, María Paz Boza, Ricardo León-Rodríguez, Bernal Luftig, Ronald B. Visoná, Kirsten |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Taylor-Castillo, Lizeth Herrera-Martínez, Gisela León-Bratti, María Paz Boza, Ricardo León-Rodríguez, Bernal Luftig, Ronald B. Visoná, Kirsten |
dc.subject.por.fl_str_mv |
Human immunodeficiency virus Anti-retroviral treatment Resistance mutations Highly active antiretroviral therapy Risk factors Response Adherence |
topic |
Human immunodeficiency virus Anti-retroviral treatment Resistance mutations Highly active antiretroviral therapy Risk factors Response Adherence |
description |
INTRODUCTION: Information about HIV phenotypes of resistant to available ART and the influence of different risk factors on virological failures (VF) in Costa Rican HIV positive patients prior or during HAART is unknown. MATERIALS AND METHODS: Eighty nine samples, 72 VF and 17 basal (before treatment) were analyzed by examining resistant mutants in reverse transcriptase (RT) and protease (PT) regions using Trugene or LIPA genotyping kits. Sixty eight control patients were selected and relevant information was collected in a questionnaire. RESULTS: Poor adherence, presence of resistant mutations and number of treatment's changes were the only significant factors found (p = 0.006, 0.04 and 0.01 respectively). From 66 sequenced samples, 78%, 50% and 50% showed resistance to NRTI (nucleoside reverse transcriptase inhibitors), NNRT (non-nucleoside reverse transcriptase inhibitors) and PI (protease inhibitors), respectively. The most frequent mutations were M41L, M184V, and T215FY in RT and L62PI, L10FIRV and M36I in PT. DISCUSSION: The most important factor related to treatment response in this study was adherence to treatment. Mutations in RT were related to the treatment failure while the ones found in PT were secondary mutations which have been previously described to influence the selection of primary resistance mutations in these regions. The study reveals the urgency to detect resistant mutations in VF to be considered by physicians for selection of treatment schedule, to analyze basal HIV patients for monitoring of the spread of resistant mutations and the importance to reinforce the adherence in the patients for overall treatment outcome. |
publishDate |
2005 |
dc.date.none.fl_str_mv |
2005-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30950 |
url |
https://www.revistas.usp.br/rimtsp/article/view/30950 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30950/32834 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 47 No. 6 (2005); 327-331 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 47 Núm. 6 (2005); 327-331 Revista do Instituto de Medicina Tropical de São Paulo; v. 47 n. 6 (2005); 327-331 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
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1798951645636198400 |