Secondary mutations in the protease region of human immunodeficiency virus and virologic failure in drug-naive patients treated with protease inhibitor-based therapy

C. F. Perno, A. Cozzi-Lepri, C. Balotta, F. Forbici, M. Violin, A. Bertoli, G. Facchi, P. Pezzotti, G. Cadeo, G. Tositti, S. Pasquinucci, S. Pauluzzi, A. Scalzini, B. Salassa, A. Vincenti, A. N. Phillips, F. Dianzani, A. Appice, G. Angarano, L. MonnoG. Ippolito, M. Moroni, A. D'Arminio Monforte, M. Montroni, G. Scalise, A. Costantini, M. S. Del Prete, U. Tirelli, G. Nasti, G. Pastore, L. M. Perulli, F. Suter, C. Arici, F. Chiodo, F. M. Gritti, V. Colangeli, C. Fiorini, L. Guerra, G. Carosi, G. P. Cadeo, F. Castelli, C. Minardi, D. Vangi, G. Rizzardini, G. Migliorino, P. E. Manconi, P. Piano, T. Ferraro, L. Cosco, E. Pizzigallo, F. Ricci, G. M. Vigevani, L. Pusterla, G. Carnevale, A. Pan, P. Viganò, M. Mena, F. Ghinelli, L. Sighinolfi, F. Leoncini, F. Mazzotta, S. Ambu, S. Lo Caputo, G. Angarano, B. Grisorio, S. Ferrara, P. Grima, P. Tundo, G. Pagano, N. Piersantelli, A. Alessandrini, R. Piscopo, M. Toti, S. Chigiotti, F. Soscia, L. Tacconi, A. Orani, G. Castaldo, A. Scasso, A. Vincenti, A. Scalzini, F. Alessi, M. Moroni, A. Lazzarin, A. Cargnel, F. Milazzo, L. Caggese, A. D'Arminio Monforte, S. Melzi, F. Delfanti, B. Carini, B. Adriani, S. Garavaglia, C. Moioli, R. Esposito, C. Mussini, N. Abrescia, A. Chirianni, O. Perrella

Research output: Contribution to journalArticlepeer-review

Abstract

The role of mutations in protease (PR) and reverse-transcriptase (RT) of human immunodeficiency virus (HIV) in predicting virologic failure was assessed in 248 antiretroviral-naive HIV-positive patients who began a PR inhibitor-containing antiretroviral regimen. Genotypic testing was performed on plasma samples stored before the start of therapy. Twenty-seven patients (10.9%) had mutations in the RT, 5 (2%) carried primary mutations in the PR, and 131 (52.8%) showed only secondary PR mutations. Virologic failure at week 24 occurred in 62 (25.0%) of 248 patients. There was a statistically significant correlation between virologic failure and the number of PR mutations (P=.04, X2 test). Mutations at codons 10 and 36 of PR (present in 39.3% and 40.0% of patients in whom treatment failed, respectively) were identified by stepwise logistic regression as the strongest predictors of virologic failure (odds ratio, 2.20; 95% confidence interval, 1.30-3.75; P=.004). If confirmed in independent studies, this result may justify the increased use of HIV genotyping in drug-naive patients requiring antiretroviral therapy.

Original languageEnglish
Pages (from-to)983-991
Number of pages9
JournalJournal of Infectious Diseases
Volume184
Issue number8
DOIs
Publication statusPublished - Oct 15 2001

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

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