TY - JOUR
T1 - Evolution and predictors of HIV types-1 drug resistance in patients failing combinatin antiretroviral therapy in Italy
AU - Di Giambenedetto, Simona
AU - Zazzi, Maurizio
AU - Corsi, Paola
AU - Gonnelli, Angela
AU - Di Pietro, Massimo
AU - Giacometti, Andrea
AU - Almi, Paolo
AU - Trezzi, Michele
AU - Boeri, Enzo
AU - Gianotti, Nicola
AU - Menzo, Stefano
AU - Del Gobbo, Romana
AU - Francisci, Daniela
AU - Nerli, Alessandro
AU - Galli, Luisa
AU - De Luca, Andrea
PY - 2009
Y1 - 2009
N2 - Background: This study aimed to examine the evolution of genotypic drug resistance prevalence in treatment-failing patients in the multicentre, Italian, Antiretroviral Resistance Cohort Analysis (ARCA). Methods: Patients with a drug resistance genotype test performed between 1999 and 2006 at failure of a combination antiretroviral therapy and with complete treatment history were selected. The prevalence of resistance. was measured overall, per calendar year, per drug class and per treatment line at failure. Results: The Overall resistance prevalence was 81%. Resistance to nucleoside reverse transcriptase inhibitors (NRTIs) declined after 2002, (68% in 2006; for trend P=0.004); resistance to noh-NRTIs (NNRTIs) stabilized after 2004; and resistan to protease inhibitors (Pls) declined after 2001 (43% in 2006; P=0.004). In first-line failures, NRTI resistance decreased after 2002 (P=0.0006), NNRTI resistance decreased after 2003 (P=0.001) and PI resistapear decreased after 2001 (P+ T-cell counts, more recent calendar year and viral subtype B carriage, whereas the use of PI-based versus NNRTI-based regimens at failure was associated with a reduced risk of resistance. There was an increase of type-1 thymidine analogue and of protease mutations L33F, I47A/V, I50V and I54L/M whereas L90M decrease over calendar years. Conclusions: During more recent years, emerging drug resistance has decreased, particularly in first-line failures. The prevalence continues to be high in mutiregimen-failing patients.
AB - Background: This study aimed to examine the evolution of genotypic drug resistance prevalence in treatment-failing patients in the multicentre, Italian, Antiretroviral Resistance Cohort Analysis (ARCA). Methods: Patients with a drug resistance genotype test performed between 1999 and 2006 at failure of a combination antiretroviral therapy and with complete treatment history were selected. The prevalence of resistance. was measured overall, per calendar year, per drug class and per treatment line at failure. Results: The Overall resistance prevalence was 81%. Resistance to nucleoside reverse transcriptase inhibitors (NRTIs) declined after 2002, (68% in 2006; for trend P=0.004); resistance to noh-NRTIs (NNRTIs) stabilized after 2004; and resistan to protease inhibitors (Pls) declined after 2001 (43% in 2006; P=0.004). In first-line failures, NRTI resistance decreased after 2002 (P=0.0006), NNRTI resistance decreased after 2003 (P=0.001) and PI resistapear decreased after 2001 (P+ T-cell counts, more recent calendar year and viral subtype B carriage, whereas the use of PI-based versus NNRTI-based regimens at failure was associated with a reduced risk of resistance. There was an increase of type-1 thymidine analogue and of protease mutations L33F, I47A/V, I50V and I54L/M whereas L90M decrease over calendar years. Conclusions: During more recent years, emerging drug resistance has decreased, particularly in first-line failures. The prevalence continues to be high in mutiregimen-failing patients.
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M3 - Article
C2 - 19474470
AN - SCOPUS:67649147982
SN - 1359-6535
VL - 14
SP - 359
EP - 369
JO - Antiviral Therapy
JF - Antiviral Therapy
IS - 3
ER -