摘要：This
study aimed to investigate
resistance mutation in patients under discontinued antiretroviral (ARV) therapy.
Material and methods. Selection of
reverse-transcriptase (RT) and protease mutations was investigated in 48
pediatric patients treated for at least 52 weeks by tritherapy including
non-nucleoside inhibitors but whose treatment was discontinued for at least
three times (< 1 week) during the follow-up, mainly due to lack of financial
resources. Viral load (VL) was measured by Monitor Roche (detection limit: 200
copies/mL). Results. All the
patients were infected by HIV-1 subtype F1. VL was undetectable in 5 patients.
RT and protease were amplified in 44 and 42 patients respectively. Wild-type
protease was observed in 29 patients, while wild RT was observed in 3 cases. 4
patients with detectable VL had non-nucleoside inhibitors of
reverse-transcriptase (NNRTI) mutations (K103N=30; Y181C=6; Y188L=2; V106M=1).
Four of them presented substitutions associated with high-level resistance to
NRTI (M184V=2; T215Y=2), whereas 13 patients presented substitutions associated
with resistance to PI (M46I; V82A). All the patients presenting substitutions
associated with the resistance to PI also presented mutations associated with
resistance toward NNRTI. Conclusions. Our results show a very high frequency
of selection of NNRTI mutations in patients receiving a discontinued treatment
containing this class of drugs. NNRTIs should be avoided in those situations
where for economical reasons there are risks of discontinuations of
treatment.
关键词：HIV-1, reverse-transcriptase, protease, ARV resistance mutations
