Rapid accumulation of nonnucleoside reverse transcriptase inhibitor-associated resistance: evidence of transmitted resistance in rural South Africa
Rapid accumulation of nonnucleoside reverse transcriptase inhibitor-associated resistance: evidence of transmitted resistance in rural South Africa
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DOI：
10.1097/qad.0b013e328313bf87
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发表时间：
2008-10-18
期刊：
影响因子：
3.8
通讯作者：
Hoepelman, Andy I.
中科院分区：
文献类型：
--
作者：
Barth, Roos E.;Wensing, Annemarie M.;Hoepelman, Andy I.
在南非农村的一个大型队列中，开始进行高效抗逆转录病毒治疗的C亚型感染患者中有73%实现了病毒抑制。在随后的病毒学失败患者中，观察到了意外的、快速积累的非核苷逆转录酶抑制物相关突变，而没有出现胸苷类似物相关突变。似乎有几名患者在开始抗逆转录病毒治疗之前有药物相关的突变，这表明耐药性的传递可能导致了非核苷逆转录酶抑制物突变的积累。重要的是，监测HIV-RNA并及时切换治疗可能会防止胸腺嘧啶核苷类似物相关突变的发展。
In a large cohort in rural South Africa, 73% of subtype-C-infected patients initiating highly active antiretroviral therapy achieved viral suppression. In patients with subsequent virological failure, an unexpected, rapid accumulation of nonnucleoside reverse transcriptase inhibitor-associated mutations was observed, whereas no thymidine analogue-associated mutations emerged. It appeared that several patients had drug-associated mutations prior to starting antiretrovirals, suggesting that transmission of resistance may have contributed to the accumulation of nonnucleoside reverse transcriptase inhibitor-mutations. Importantly, monitoring of HIV-RNA and prompt switch of treatment may prevent development of thymidine analogue-associated mutations.