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Id:3299
Autor:Tanuri, Amilcar; Teixeira, Paulo R; Chequer, Pedro N.
Título:Prevalence of mutations related to HIV-1 antiretroviral resistance in Brazilian patients failing HAART.
Fonte:J Clin Virol;25(1):34-46, jul.2002. .
Resumo:BACKGROUND: Current guidelines for antiretroviral (ARV) therapy recommend at least triple-drug combination, the so-called highly active antiretroviral therapy (HAART). Not all patients respond to HAART and the development of drug resistance remains one of the most serious obstacles to sustained suppression of HIV. OBJECTIVE: In an attempt to correlate the HIV therapeutic failure with reverse transcriptase (RT) and protease resistance mutations, we describe the ARV resistance profile in patients failing HAART in Brazil. We studied 267 Brazilian HIV-1 infected patients failing HAART looking for mutations in RT and protease genes. The mutation profile of the viruses infecting these individuals were deduced and correlated to laboratorial parameters. STUDY DESIGN: Two different HIV-1 genomic regions were targeted for PCR amplification, the protease (pro) and pol RT (palm finger region) genes. The mutations related to drug resistance in RT gene was analyzed using a line probe assay (LIPA(R)) and pro amino acids positions 82 and 90 were screened through RFLP using HincII restriction digestion. RESULTS: There was strong correlation between the mutation in the pro and RT genes and therapeutic failure. The main mutation found in RT gene was the M184V (48%) followed by T69D/N (47%), T215Y/F (46%), M41L (39%), and L74V (7%). In the pro gene the main mutation found was L90M (26%) followed by dual substitution in L90M and V82A (6%). All mutations profiles matched very well with the patients drug regimen. CONCLUSIONS: This study has shown that 84.7% of HIV infected subjects failing HAART for more than 3 months presented viral genomic mutations associated with drug resistance.
Descritores:Terapia Anti-Retroviral de Alta Atividade
Estudos Transversais
Infecções por HIV/quimioter
Infecções por HIV/epidemiol
Infecções por HIV/virol
Protease de HIV/genet
Transcriptase Reversa do HIV-1/genet
Prevalência
Falha de Tratamento
Brasil/epidemiol
 Resistência Viral a Drogas/genet
 HIV-1/ef drogas
 HIV-1/genet
 Mutação
Limites:Humano
Localização:BR1310.1; PAPROF



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