Antiretroviral Genotypic Resistance Mutations in HIV-1 Infected Korean Patients with Virologic Failure.
10.3346/jkms.2009.24.6.1031
- Author:
Bum Sik CHIN
1
;
Ju Yeon CHOI
;
Jin Young CHOI
;
Gab Jung KIM
;
Mee Kyung KEE
;
June Myung KIM
;
Sung Soon KIM
Author Information
1. Division of AIDS, Center for Immunology and Pathology, Korea National Institute of Health, Seoul, Korea. sungskim@nih.go.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
HIV-1;
Treatment Failure;
Drug Resistance;
Genotype
- MeSH:
Adult;
Aged;
*Antiretroviral Therapy, Highly Active;
Biological Assay/methods/utilization;
Drug Resistance, Viral/*genetics;
Female;
HIV Infections/*drug therapy/genetics;
HIV-1/*genetics;
Humans;
Male;
Middle Aged;
*Mutation;
Treatment Outcome;
Viral Load;
Young Adult
- From:Journal of Korean Medical Science
2009;24(6):1031-1037
- CountryRepublic of Korea
- Language:English
-
Abstract:
Resistance assays are useful in guiding decisions for patients experiencing virologic failure (VF) during highly-active antiretroviral therapy (HAART). We investigated antiretroviral resistance mutations in 41 Korean human immunodeficiency virus type 1 (HIV-1) infected patients with VF and observed immunologic/virologic response 6 months after HAART regimen change. Mean HAART duration prior to resistance assay was 45.3+/-27.5 months and commonly prescribed HAART regimens were zidovudine/lamivudine/nelfinavir (22.0%) and zidovudine/lamivudine/efavirenz (19.5%). Forty patients (97.6%) revealed intermediate to high-level resistance to equal or more than 2 antiretroviral drugs among prescribed HAART regimen. M184V/I mutation was observed in 36 patients (87.7%) followed by T215Y/F (41.5%) and M46I/L (34%). Six months after resistance assay and HAART regimen change, median CD4+ T cell count increased from 168 cells/microliter (interquartile range [IQR], 62-253) to 276 cells/microliter (IQR, 153-381) and log viral load decreased from 4.65 copies/mL (IQR, 4.18-5.00) to 1.91 copies/mL (IQR, 1.10-3.60) (P<0.001 for both values). The number of patients who accomplished viral load <400 copies/mL was 26 (63.4%) at 6 months follow-up. In conclusion, many Korean HIV-1 infected patients with VF are harboring strains with multiple resistance mutations and immunologic/virologic parameters are improved significantly after genotypic resistance assay and HAART regimen change.
