BALAGUERA HU, HANNA GJ, FREEDBERG KA, STEGER KA, DAQUILA RT, CRAVEN DE; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 303.

Boston Med. Ctr., Boston, MA

BACKGROUND: Data are limited on the prevalence of genotypic resistance (GR) to nucleoside & non-nucleoside reverse transcriptase inhibitors (NRTI & NNRTI) and protease inhibitors (PI) in HIV-infected, antiretroviral-naive adults.METHODS: The prevalence of GR in a diverse urban population of antiretroviral-naive patients entering care at Boston Med. Ctr. in 1999 was analyzed using the TruGene HIV-1 assay (Visible Genetics).RESULTS: The study group included 45 adults: mean age (+/-SD) = 38 +/-9 years, 42% female; 20% white, 46% African-American, 8% Latino, 9% African, and 16% from the Caribbean Basin. Risk behaviors included injection drug use (IDU) (36%), heterosexual sex (47%) and men who have sex with men (18%). HIV-bDNA levels were <10,000 copies/ml in 22%, 10,000-100,000 in 45% and >100,000 in 33%; CD4 counts <200/micro-l in 44%, CD8 counts >865/micro-l in 31%, and hepatitis C antibody was detected in 36%. Major GR mutations were identified in 7 cases (16%): 5 to NRTIs; M41L/L210W (zidovudine (AZT)), E44D and V118I/V (lamivudine (3TC)), M69T/N and T69S (multi-NRTIs); 1 NNRTI : K103N (multi-NNRTIs); and 1 PI: L90M/L (multi-PIs). Compared to the 38 patients without GR, there was an increase in GR-associated with CD8 counts >865/micro-l vs <865/micro-l, p<0.05. Trends toward increased GR were noted for males (p=0.1), African American vs other racial ethnic groups (p=0.09) and with higher mean bDNA in copies/ml (224,187+/-220,923 vs 105,852+/-143,596, p=0.07). Two patients, one with AZT GR and one with NNRTI GR had complete suppression (<50 copies/ml) for >18 months on therapy with AZT/3TC/efavirenz.CONCLUSIONS: GR to antiretrovirals was 16% in antiretroviral-naive patients and was associated with higher mean CD8 counts.KEYWORDS: Antiretrovirals; HIV genotyping; HIV infection

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Adult
• Boston
• Caribbean Region
• Female
• HIV Infections
• HIV Seropositivity
• HIV-1
• Humans
• Lamivudine
• Male
• Mutation
• Oxazines
• Prevalence
• Reverse Transcriptase Inhibitors
• Zidovudine
• efavirenz
• genetics
• reverse transcriptase, Human immunodeficiency virus 1

Other ID:

• GWAIDS0009461

UI: 102246959

From Meeting Abstracts