Thymidine analogue mutations in antiretroviral-naive HIV-1 patients on triple therapy including either zidovudine or stavudine.
Thymidine analogue mutations in antiretroviral-naive HIV-1 patients on triple therapy including either zidovudine or stavudine.
复制标题
接受齐多夫定或司他夫定三联疗法的未接受过抗逆转录病毒治疗的 HIV-1 患者中胸苷类似物突变。
DOI：
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发表时间：
2003
影响因子：
5.2
通讯作者：
Y. Mouton
中科院分区：
文献类型：
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作者：
L. Bocket;Y. Yazdanpanah;F. Ajana;Y. Gérard;N. Viget;A. Goffard;I. Alcaraz;P. Wattré;Y. Mouton
旨在
本研究的目的是：（i）确定胸苷相关突变（TAM）的发生率在一个观察性临床队列的初治HIV-1患者谁停止一线治疗，包括齐多夫定或司他夫定;和（ii）评估免疫和病毒学反应，随后二线治疗的患者谁从齐多夫定转换为司他夫定或相反。
患者和方法
从165例停止一线抗逆转录病毒治疗的患者中检测了耐药基因型的存在。随后对136例从齐多夫定改为司他夫定或相反的患者进行了二线免疫学和病毒学随访。
结果
在93例停止一线治疗（包括齐多夫定）的患者和72例停止一线治疗（包括司他夫定）的患者中，分别有67例（72%）和54例（75%）进行了基因型耐药检测。齐多夫定组TAM的发生率显著高于司他夫定组（23.8% vs 5.5; P = 0.006）。尽管齐多夫定组和司他夫定组的基线病毒耐药情况不同，但对二线治疗的短期和长期免疫学和病毒学应答相当（治疗1年时CD 4细胞/mm 3的中位数增加，118 vs 119;病毒载量<400拷贝/mL，47% vs 47%）。
结论
这些结果表明，TAM发生在更多的患者抗逆转录病毒治疗方案，包括齐多夫定比方案，包括司他夫定。虽然观察性研究的结果应谨慎解释，这些发现可能有助于确定齐多夫定和司他夫定治疗初治HIV-1感染患者的最佳顺序。
AIMS
The aims of this study were to: (i) determine the incidence of thymidine-associated mutations (TAMs) in an observational clinical cohort of naive HIV-1 patients who stopped first-line therapy including either zidovudine or stavudine; and (ii) assess the immunological and virological responses to subsequent second-line therapy in patients who switched from zidovudine to stavudine or conversely.
PATIENTS AND METHODS
Plasma samples from 165 patients who stopped first-line antiretroviral therapy containing either zidovudine or stavudine were examined for the presence of drug-resistant genotypes. Subsequent second-line immunological and virological follow-up was performed in 136 patients who switched from zidovudine to stavudine and conversely.
RESULTS
Among the 93 patients who stopped first-line therapy including zidovudine and the 72 who stopped first-line therapy including stavudine, genotypic resistance testing was available for 67 (72%) and 54 (75%), respectively. The presence of TAMs was significantly more frequent in the zidovudine than the stavudine group (23.8% versus 5.5; P = 0.006). The short- and long-term immunological and virological responses to second-line therapy were comparable in the zidovudine and stavudine groups, despite different baseline profiles of viral resistance (median increase in CD4 cells/mm3 at 1 year of therapy, 118 versus 119; viral load <400 copies/mL, 47% versus 47%).
CONCLUSIONS
These results suggest that TAMs occur in more patients on antiretroviral regimens including zidovudine than on regimens including stavudine. Although the results from observational studies should be interpreted cautiously, these findings may be useful in determining the optimal sequencing of zidovudine and stavudine for the treatment of naive HIV-1-infected patients.
两个人类免疫缺陷病毒感染的法国临床队列中原发性机会性感染的发生率。
影响因子：
7.7
作者：
Yazdanpanah,Y;Chêne,G;Losina,E;Goldie,SJ;Merchadou,LD;Alfandari,S;Seage3rd,GR;Sullivan,L;Marimoutou,C;Paltiel,AD;Salamon,R;Mouton,Y;Freedberg,KA
通讯作者：
Freedberg,KA