Failure of stavudine-lamivudine combination therapy in antiretroviral-naive patients with AZT-like HIV-1 resistance mutations

被引:10
作者
Sarmati, L
Nicastri, E
Parisi, SG
D'Ettorre, G
Narciso, P
Mancino, G
Gallo, I
Abbadessa, V
Dalle, NER
Traina, C
Vullo, V
Andreoni, M
机构
[1] Univ Roma Tor Vergata, Dept Publ Hlth, Rome, Italy
[2] Univ Verona, Dept Infect Dis, I-37100 Verona, Italy
[3] Univ Roma La Sapienza, Dept Infect Dis, Rome, Italy
[4] IRCCS L Spallanzani Rome, Rome, Italy
[5] Umberto I Hosp, Frosinone, Italy
[6] Univ Palermo, Dept Infect Dis, Palermo, Italy
[7] Casa Sole Hosp, Palermo, Italy
关键词
AZT resistance; antiretroviral therapy; stavudine-lamivudine combination therapy;
D O I
10.1002/jmv.2083
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
To analyze the clinical relevance of AZT resistance mutations in AZT-naive patients, 56 HIV-1 seropositive patients treated for 18 months with stavudine/lamivudine (27 patients) or AZT/lamivudine (29 patients) were studied. AZT-like resistance mutations were found in 13 out of 29 (44%) patients treated with AZT/lamivudine and in 11 out of 27 (40%) patients treated with stavudine/lamivudine. No stavudine or multidrug resistance mutations were detected. After 26 months of treatment more than 60% of patients showed a virological failure. Among 10 patients failing treatment with stavudine/lamivudine, 9 had AZT-like resistance mutations. The phenotypic test, performed on HIV-1 strains isolated from six of these nine patients, showed a resistance to AZT in five isolates and to stavudine in two isolates. The genotypic pattern of the latter two isolates showed the combined mutations M184V plus R211K and L214F. AZT-like resistance mutations in AZT-naive patients seem to correlate with a virological failure during long-term stavudine therapy. (C) 2001 Wiley-Liss, Inc.
引用
收藏
页码:631 / 636
页数:6
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