Genotypic resistance and the treatment of HIV-1 infection in Espirito Santo, Brazil

11Citations
Citations of this article
21Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Before December 1997, in Espirito Santo, Brazil, combination antiretroviral therapy was used without routine virologic or immunologic monitoring. To examine consequences of therapy in this setting, clinical information, human immunodeficiency virus type 1 (HIV-1) RNA levels, CD4 cell counts, and protease and reverse transcriptase sequences were determined for consecutive HIV-1-infected outpatients. Of 48 treatment-naive individuals, 11 were started on therapy for HIV-related symptoms; however, 44 (92%) had an RNA level >20,000 copies/mL, a CD4 cell count <500/mm3, or symptoms. Eighteen (51%) of 35 patients on therapy had an RNA level >20,000 copies/mL. Nucleoside-resistance mutations were observed in 31 (68%) of 31 nucleoside- experienced subjects. Protease mutations necessary for high-level protease inhibitor (PI) resistance were present together with permissive mutations in 3 of 10 PI-experienced patients. Inability to identify high-risk individuals and to detect virologic failure may limit the effectiveness of antiretroviral drug programs and may promote the spread of drug resistance where virologic and immunologic monitoring are not available.

Cite

CITATION STYLE

APA

Pilcher, C. D., Perkins, M. D., Fiscus, S. A., Johnston, D. M., Dietze, R., Duque, U. H., … Eron, J. J. (1999). Genotypic resistance and the treatment of HIV-1 infection in Espirito Santo, Brazil. Journal of Infectious Diseases, 179(5), 1259–1263. https://doi.org/10.1086/314709

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free