Frequency of genotypic and phenotypic drug-resistant HIV-1 among therapy-naive patients of the German Seroconverter Study
Frequency of genotypic and phenotypic drug-resistant HIV-1 among therapy-naive patients of the German Seroconverter Study
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DOI：
10.1097/00126334-200103010-00010
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发表时间：
2001-03-01
期刊：
影响因子：
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通讯作者：
Kücherer, C
中科院分区：
文献类型：
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作者：
Duwe, S;Brunn, M;Kücherer, C
在柏林罗伯特·科赫研究所协调的德国血清转换器研究中，对治疗的初治的、感染艾滋病毒-1的血清转换器进行了病毒逆转录酶(RT)和蛋白水解酶(PR)的基因型和表型耐药性测定。患者血清转换日期：并记录实验室、临床和治疗随访数据。样本收集于1996至1999年间。在8例(13%)血清转换者中发现了表型耐药的HIV-1：大多数情况下耐药性较弱，主要针对RT抑制剂(4种核苷逆转录酶抑制剂[NRTI]，2种非核苷逆转录酶抑制剂[NNRTI]，1种NRTI/NNRTI组合)。只有一例感染对PR抑制剂耐药较弱。目前还没有观察到耐多药艾滋病毒-1的传播。通过基因分型分析，经常检测到至少一个或多个与抗逆转录病毒耐药性相关的氨基酸突变。自1996年以来，传播的病毒：RT中与耐药性相关的突变的平均数量显著增加。研究表明，如果基于基因耐药数据，最初的抗逆转录病毒治疗的好处会有所改善。鉴于耐药HIV-1在德国的传播水平相当高，在欧洲和美国的其他研究中也可以看到这一点，我们建议在开始治疗新感染的HIV-1患者之前确定基因耐药模式。
Genotypic and phenotypic resistance of viral reverse transcriptase (RT) and protease (PR) was determined for 64 therapy-naive, HIV-1-infected seroconverters of the German Seroconverter Study coordinated by the Robert Koch-Institut, Berlin. The date of seroconversion of patients: and the laboratory, clinical, and therapeutic follow-up data were documented. Samples were collected between 1996 and 1999. Phenotypic resistant HIV-1 were found in 8 (13%) seroconverters: in most cases resistance was weak and mainly directed against RT inhibitors (4 nucleoside reverse transcriptase inhibitors [NRTIs], 2 nonnucleoside reverse transcriptase inhibitors [NNRTIs], 1 combination NRTI/NNRTI). Only one infection with a weak PR inhibitor resistance was identified. Transmission of multidrug-resistant HIV-1 has not yet been observed. Frequently at least one or more amino acid mutations associated with antiretroviral drug resistance were detected by genotypic analysis. The mean number of resistance-associated mutations in the: RT of the transmitted virus has increased significantly since 1996. Studies have shown the improved benefit of initial antiretroviral therapy if based on genotypic resistance data. In view of the considerably high level of transmission of resistant HIV-1 in Germany, which is also seen in other studies in Europe and the United States, we suggest determining the genotypic resistance pattern before starting therapy of newly HIV-1-infected patients.