HIV-1 drug-resistance patterns among patients on failing treatment in a large number of European countries

David A.M.C. Van De Vijver, Annemarie M.J. Wensing, Birgitta Åsjö, Marie Bruckova, Louise Bruun Jorgensen, Ricardo Camacho, Andrzej Horban, Marek Linka, Marios Lazanas, Clive Loveday, Eilidh MacRae, Claus Nielsen, Dimitrios Paraskevis, Mario Poljak, Elisabeth Puchhammer-Stöckl, Lidia Ruiz, Jean Claude Schmit, Grzegorz Stanczak, Maja Stanojevic, Anne Mieke VandammeJurgen Vercauteren, Maurizio Zazzi, Lee Bacheler, Pierre Lecocq, Jorge Villacian, Charles A.B. Boucher

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Information about patterns of HIV-1 drug resistance among treatment-exposed patients is crucial for the development of novel effective drugs. Currently no system exists that monitors patterns of resistance in patients failing therapy. Methods: The study included 1,988 HIV-1 sequences from patients experiencing therapy failure collected between 2000 and 2004 in 15 European countries. Genotypic resistance was interpreted using the ANRS algorithm. Phenotypic resistance was predicted using the Virco geno- to phenotype system. Results: 80.7% of the sequences included at least one drug-resistance mutation. Mutations were found for NRTIs (73.5%), NNRTIs (48.5%), and protease inhibitors (35.8%). Ninety percent of sequences with genotypic resistance harbored M184V, M41L, K103N, D67N, and/or T215Y. Among NRTIs, resistance was most frequently predicted for lamivudine. About half of all sequences had reduced susceptibility for NNRTIs. Resistance to most boosted protease inhibitors was found in < 25%. No sequence had resistance to all currently available drugs. Conclusion: Levels of resistance among patients with therapy failure were high. The patterns of resistance reflect resistance to drugs available for a longer time. Fully suppressive regimens can be designed even for the most mutated HIV because boosted protease inhibitors have remained active against most circulating viruses and new drug classes have become available.

Original languageEnglish
Pages (from-to)3-9
Number of pages7
JournalActa Dermatovenerologica Alpina, Pannonica et Adriatica
Volume19
Issue number4
Publication statusPublished - Dec 2010

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