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Abstract
The presence of a single canonical NNRTI resistance mutation in naïve HIV-1 infected patients reduces the proportion achieving virological success when starting NNRTI-based regimens.
Price H.1, Jones R.1, Mandalia S.1, Bower M.1, Nelson M.1, Gazzard B.1
1Chelsea & Westminster Hospital, London, United Kingdom
Introduction: There is a 10% prevalence of resistance mutations in plasma samples from antiretroviral (ARV) naïve patients. This study examines whether this influences the result of treatment.
Methods: Between 2000 and 2003, 808 patients had a resistance test retrospectively performed on a stored sample taken prior to initiating therapy with either a PI-based regimen, an NNRTI-based regimen or nucleoside analogues only. The proportion of patients who were virologically undetectable within six months was assessed.
Results:
| | n | Rx PI | Rx NN | Rx NA Only | | PI mutation | 28 | 5 ex 6 | 17 ex 19 | 2 ex 3 | | NNRTI mutation | 49 | 13 ex 15 | 19 ex 31 | 2 ex 3 | | Multiple mutations | 27 | 4 ex 9 | 8 ex 14 | 3 ex 4 | | No mutations | 704 | 98 ex 155 | 397 ex 506 | 29 ex 43 |
Conclusions: More than half the patients treated with NNRTI regimens responded despite pre-existing resistance although response to a PI containing regimen was better.
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