摘要：This study was aimed to investigate the efficiency of
the ARV management based on plasma genotypic antiretroviral resistance testing
in patients with failing ARV therapy. Material and methods. There were
included 48 of patients in which ARV therapy was modulated according to the
results of genotypic resistance which registered therapeutic failure in 43 of
cases (89.6%) in 2000. In 2001 out of 42 plasma samples, viral load was
undetectable in 23 (55%). The protease was amplified in 19/42 of cases, ten of
which being wild type. Results. New
resistance mutations comparing to 2000 were observed in proteases from 7
patients. Reverse-transcriptase (RT) was amplified in 19/42 patients and new
resistance mutations were observed in 4. These mutations conferred resistance
toward nucleozid inhibitors of RT (NNRTIs). Reverse-mutations occurred very
rarely following therapeutic switch. Conclusion . Our study shows that
monitoring the ARV therapy based on genotypic testing is highly effective in
controlling the HIV infection evolution. The low rates of reverse mutations
following the therapeutic switch stress the importance of the responsible
treatment monitoring.
