Non-nucleoside reverse transcriptase inhibitor resistance among patients failing a nevirapine plus protease inhibitor-containing regimen

摘要: Objective: To determine the rate of nevirapine resistance in patients failing a plus protease inhibitor (PI)-based regimen, and whether these isolates remain susceptible to other non-nucleoside reverse transcriptase inhibitors (NNRT1). Design setting: A retrospective cohort study two tertiary university hospitals. Patients: Eighty-eight HIV-infected, NNRTI-naive receiving PI as rescue regimen after treatment failure. Main outcome measures: Genotypic phenotypic data at inclusion (73 60 plasma samples, respectively) 24 weeks (53 42 samples). Results: Baseline susceptibility was found 70% patients, similar were observed for efavirenz (91%) delavirdine (71%). NNRTI resistance-associated mutations 11 (12.5%). At weeks, resistant 92% correlated with (68%) (73%). In genotypic analysis, Y181C mutation 76% mutants, most common changes combination positions Y181C/K103N (23%) single (15%). The development associated baseline included (P = 0.01). For containing amino acid substitution Y181C, 29% remained fully efavirenz, whereas 14% showed intermediate delavirdine. Conclusion: failure PI-containing is occurring residue 181. Although there high degree cross-resistance among NNRTI, nearly one third carrying efavirenz.