Evaluation of HIV-1 resistance to antiretroviral drugs among 150 patients after six months of therapeutic interruption
Kalmar, E. M. N.
Sanabani, S. S. [UNIFESP]
Costa, A. Charlys da [UNIFESP]
Barreto, C. C.
Sabino, E. C.
Is part ofInternational Journal of Std & Aids
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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.
CitationInternational Journal of Std & Aids. London: Royal Soc Medicine Press Ltd, v. 23, n. 2, p. 120-125, 2012.
SponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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