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Titolo:
Transient relapses ("blips") of plasma HIV RNA levels during HAART are associated with drug resistance
Autore:
Stuart, JWTC; Wensing, AMJ; Kovacs, C; Righart, M; de Jong, D; Kaye, S; Schuurman, R; Visser, CJT; Boucher, CAB;
Indirizzi:
Univ Utrecht, Med Ctr, Dept Virol, Eijkman Winkler Inst, NL-3584 CX Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3584 CX 3584 CX Utrecht, Netherlands Univ Toronto, Dept Emergency Med, Div Internal Med, Toronto, ON, Canada Univ Toronto Toronto ON Canada ed, Div Internal Med, Toronto, ON, Canada Royal Free & Univ Coll, Sch Med, Dept Virol, London, England Royal Free & Univ Coll London England Med, Dept Virol, London, England
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 2, volume: 28, anno: 2001,
pagine: 105 - 113
SICI:
1525-4135(20011001)28:2<105:TR(OPH>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNODEFICIENCY-VIRUS TYPE-1; POTENT ANTIRETROVIRAL THERAPY; REVERSE-TRANSCRIPTASE; PROTEASE INHIBITOR; INFLUENZA VACCINATION; COMBINATION THERAPY; PHENOTYPIC ANALYSIS; LAMIVUDINE 3TC; ZIDOVUDINE; INFECTION;
Keywords:
antiretroviral therapy; transient viral load relapse; resistance; genotype;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Wensing, AMJ Univ Utrecht, Med Ctr, Dept Virol, Eijkman Winkler Inst, GO4-614,Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands Univ Utrecht GO4-614,Heidelberglaan 100 Utrecht Netherlands NL-3584 CX
Citazione:
J.W.T.C. Stuart et al., "Transient relapses ("blips") of plasma HIV RNA levels during HAART are associated with drug resistance", J ACQ IMM D, 28(2), 2001, pp. 105-113

Abstract

Introduction: In a large number of patients on HAART who achieved plasma HIV RNA levels below the limit of detection (50 copies/ml), transient relapses of HIV RNA levels ("blips") are observed. Objective: To determine whether relapses of plasma HIV RNA during HAART are associated with development of drug resistance. Methods: Plasma samples from 15 patients with a transient viral load relapse during HAART were studied. All regimens contained lamivudine (3TC). We used an ultrasensitive sequence approach to analyze the presence of drug resistance mutations during the relapse. Results: The median plasma HIV RNA load of the relapse was 76 copies/ml (range 50-1239). In I I of 15 cases, a genotype of HIV could be obtained. Mutations in the RT and protease gene conferring resistance to one or more drugs were observed in 8 of 11 patients, 6 of whom had the M184V substitution. During a median follow-up of 27 months after the relapse, plasma HIV RNA levels remained undetectable in 13 of 15 patients. Conclusions: Plasma HIV RNA blips during HAART can be associated with selection of drug-resistant HIV. This indicates that viral replication may occur during HAART, probably caused by a temporary decrease in active drug concentrations. A blip containing only wild-type virus is not necessarily caused by viral replication. In this situation the raise of HIV RNA could also originate from release of wild-type viruses, caused by activation of the latent virus reservoir. Independent of the mechanism, blips did not preclude successful inhibition of viral replication during 2-year follow-up in the majority of these cases.

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Documento generato il 01/04/20 alle ore 17:21:11