Evolution of integrase resistance during failure of integrase inhibitor-based antiretroviral therapy.

摘要: Background: Although integrase inhibitors are highly effective in the management of drug-resistant HIV, some patients fail to achieve durable viral suppression. The long-term consequences inhibitor failure have not been well defined. Methods: We identified 29 individuals who exhibited evidence incomplete suppression on a regimen containing an (23 raltegravir, 6 elvitegravir). Before initiating inhibitor-based regimen, median CD4 + T-cell count and plasma HIV RNA levels were 62 cells/mm 3 4.65 log 10 copies/mL, respectively. Results: At first time-point, most common resistance pattern for subjects taking raltegravir was wild-type, followed order frequency by Q148H/K/R+G140S, N155H, Y143R/H/C. elvitegravir E92Q. Long-term associated with continued evolution, emergence high-level phenotypic resistance, decrease replicative capacity. Conclusions: wild-type during early is common, eventually develop drug resistance. This evolution gradual declines