NEW YORK (Reuters Health) - Genotypic resistance of HIV responsible for primary infection can persist for years after seroconversion, according to a report in the December 15th issue of the Journal of Acquired Immune Deficiency Syndromes.
“Up to 20% of new infections with HIV-1 are with resistant virus,” Dr. Patricia Cane from University of Birmingham Medical School in the UK, told Reuters Health. “Such resistance can compromise response to standard first-line therapy.”
Dr. Cane and colleagues monitored the persistence of HIV resistance-associated mutations after transmission for up to 3 years in 14 untreated patients.
Nucleoside reverse transcriptase inhibitor resistance mutation M41L, detected in three patients, persisted in samples obtained as late as 33 months after seroconversion, the authors report. The mutation T69N, seen in four patients, also persisted as late as 32 months after seroconversion.
Nonnucleoside reverse transcriptase inhibitor resistance mutation K103N and a multidrug-resistant mutant persisted as late as 23 and 18 months, respectively, after seroconversion, the report indicates.
Though no patient had isolated protease inhibitor (PI) resistance mutations, PI mutations in two patients with multidrug-resistant virus persisted 17 and 18 months after diagnosis.
“Thus, it is feasible to detect transmitted resistance in newly diagnosed chronic infections, not just in primary infection,” Dr. Cane said. “Consequently, where appropriate, it is worthwhile to test all new diagnoses of HIV for resistance, even where there is no indication of recent infection, so that first-line treatment, when required, can have the best chance of success.”
“It is possible that the outcomes will vary with the degree of resistance,” Dr. Cane added. “We will continue to monitor the persistence of mutant virus in those patients who remain off treatment.”
Source: J Acquir Immune Defic Syndr 2004;37:1570-1573. [ Google search on this article ]
MeSH Headings:Biological Phenomena: Biological Phenomena, Cell Phenomena, and Immunity: Biological Sciences: Biology: Drug Resistance, Microbial: Genetics: Genetics, Microbial: Microbiologic Phenomena: Pharmacogenetics: Biological SciencesCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
