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Title: Evaluation of HIV-1 resistance to antiretroviral drugs among 150 patients after six months of therapeutic interruption
Authors: Kalmar, E. M. N.
Sanabani, S. S. [UNIFESP]
Costa, A. Charlys da [UNIFESP]
Ferreira, S.
Barreto, C. C.
Chen, S.
Sabino, E. C.
Universidade de São Paulo (USP)
STD AIDS Reference & Training Ctr
Fundacao Prosangue
Universidade Federal de São Paulo (UNIFESP)
San Francisco Dept Publ Hlth
Keywords: human immunodeficiency virus
antiretroviral therapy
treatment interruption
Issue Date: 1-Feb-2012
Publisher: Royal Soc Medicine Press Ltd
Citation: International Journal of Std & Aids. London: Royal Soc Medicine Press Ltd, v. 23, n. 2, p. 120-125, 2012.
Abstract: Most of the antiretroviral (ARV) studies in Brazil have been reported in treatment-experienced and naive patients rather than in the setting of treatment interruption (TI). in this study, we analysed reasons given for TI and resistance mutations occurring in 150 HIV-1-infected patients who underwent TI. of the patients analysed, 110 (73.3%) experienced TI following medical advice, while the remaining patients stopped antiretroviral therapy (ART) of their own accord. the main justifications for TI were: ARV-related toxicities (38.7%), good laboratory parameters (30%) and poor adherence (20%). DNA sequencing of the partial pol gene was successful in 137 (91.3%) patients, of whom 38 (27.7%) presented mutations conferring ARV resistance. A higher viral load prior to TI correlated with drug resistance (P < 0.05). Our results demonstrate that there are diverse rationales for TI and that detection of resistant strains during TI most likely indicates a fitter virus than the wild type. High viral loads coupled with unprotected sex in this group could increase the likelihood of transmission of drug-resistant virus. Thus, treating physicians should be alerted to this problem when the use of ARVs is interrupted.
ISSN: 0956-4624
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