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

Loredana Sarmati, Emanuele Nicastri, Saverio Giuseppe Parisi, Gabriella D'Ettorre, Pasquale Narciso, Giorgio Mancino, Isa Gallo, Vincenzo Abbadessa, Nogare Ernesto Renato Dalle, Cino Traina, Vincenzo Vullo, Massimo Andreoni

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Abstract

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.

Original languageEnglish
Pages (from-to)631-636
Number of pages6
JournalJournal of Medical Virology
Volume65
Issue number4
DOIs
Publication statusPublished - 2001

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Keywords

  • Antiretroviral therapy
  • AZT resistance
  • Stavudine-lamivudine combination therapy

ASJC Scopus subject areas

  • Virology

Cite this

Sarmati, L., Nicastri, E., Parisi, S. G., D'Ettorre, G., Narciso, P., Mancino, G., Gallo, I., Abbadessa, V., Dalle, N. E. R., Traina, C., Vullo, V., & Andreoni, M. (2001). Failure of stavudine-lamivudine combination therapy in antiretroviral-naive patients with AZT-like HIV-1 resistance mutations. Journal of Medical Virology, 65(4), 631-636. https://doi.org/10.1002/jmv.2083