Reverse transcriptase mutations in HIV-1 infected patients treated with two nucleoside analogues: The SMART study

Nicola Gianotti, M. Setti, P. E. Manconi, F. Leoncini, F. Chiodo, L. Minoli, M. Moroni, G. Angarano, F. Mazzotta, G. Carosi, G. Antonelli, A. Lazzarin

Research output: Contribution to journalArticle

Abstract

Resistance to nucleoside reverse transcriptase inhibitors (NRTIs) was studied in 527 HIV-1-infected patients, 342 responder and 185 non-responder to two NRTIs. Responders were followed for one year to assess the incidence of clinical failure. The prevalence of the 215Y/F substitution was higher among non-responder, compared to responder patients (33.7% vs. 17%, P = 0.0005), whereas the prevalence of the 184V and of the 70R mutations was comparable between these two groups. The 74V substitution was never observed and the 75T mutation was detected in only two subjects non-responder to a stavudine including regimen. Reduced susceptibility to didanosine or stavudine was infrequent. Reduced susceptibility to zidovudine was observed in 25% of individuals failing a zidovudine including regimen, whereas reduced susceptibility to lamivudine was detected in all subjects failing a lamivudine including regimen. In the prospective analysis, patients with undetectable viral load at enrollment had a lower incidence of failure rate over one year compared to those with detectable HIV-RNA at entry (P <0.0001). A detectable viral load at enrollment was the only independent variable that predicted clinical failure over one year (P <0.0001).

Original languageEnglish
Pages (from-to)129-139
Number of pages11
JournalInternational Journal of Immunopathology and Pharmacology
Volume15
Issue number2
Publication statusPublished - 2002

Keywords

  • Drug resistance
  • HIV
  • Nucleoside reverse transcriptase inhibitor (NRTI)
  • Prospective study

ASJC Scopus subject areas

  • Pharmacology

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    Gianotti, N., Setti, M., Manconi, P. E., Leoncini, F., Chiodo, F., Minoli, L., Moroni, M., Angarano, G., Mazzotta, F., Carosi, G., Antonelli, G., & Lazzarin, A. (2002). Reverse transcriptase mutations in HIV-1 infected patients treated with two nucleoside analogues: The SMART study. International Journal of Immunopathology and Pharmacology, 15(2), 129-139.