Titre :
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Time trends in primary HIV-1 drug resistance among recently infected persons. (2002)
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Auteurs :
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Robert-M GRANT ;
Michael-P Busch ;
Margaret CHESNEY ;
Frederick-M HECHT ;
Nicholas-S HELLMANN ;
James-O KAHN ;
Teri LIEGLER ;
L.E.A. LIU ;
Christos-J PETROPOULOS ;
Maria WARMERDAM ;
Gladstone Institute of Virology and Immunology. San Francisco. CA. USA ;
Positive Health Program. San Francisco General Hospital. San Francisco. CA. USA ;
ViroLogic. South San Francisco. CA. USA
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Type de document :
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Article
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Dans :
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JAMA - Journal of the american medical association (vol. 288, n° 2, 2002)
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Pagination :
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181-188
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Langues:
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Anglais
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Mots-clés :
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Sida
;
Virose
;
Infection
;
VIH
;
Rétrovirus
;
Virus
;
Homme
;
Evolution
;
Thérapeutique
;
Thérapeutique médicamenteuse
;
Chimiothérapie
;
Médicament antirétroviral
;
Traitement antirétroviral
;
Médicament antiviral
;
Examen complémentaire
;
Prévalence
;
Etats Unis
;
Amérique
;
Hérédité
;
Immunopathologie
;
Médicament antibiotique
;
Amérique du Nord
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Résumé :
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[BDSP. Notice produite par INIST-CNRS b7fM9R0x. Diffusion soumise à autorisation]. Context Transmission of multiclass drug-resistant human immunodeficiency virus type 1 (HIV-1) may increase with wider use of antiretroviral therapy. Objective To determine trends in prevalence of HIV-1 drug resistance among recently infected individuals in a geographic area with a high penetration of antiviral treatment. Design, Setting, and Patients Consecutive case series of 225 patients referred to a San Francisco, Calif, hospital with recent HIV-1 infection from June 1996 through June 2001. Main Outcome Measure Time trends in the prevalence of genotypic and phenotypic primary drug resistance. Results Mutations associated with resistance to nonnucleoside reverse transcriptase inhibitors (NNRTIs) steadily increased from 0% in 1996-1997 to 12 (13.2%) in 2000-2001 (P=01). There was 1 mutation associated with protease inhibitor resistance in 1996-1997 (2.5%) and there were 7 (7.7%) in 2000-2001 (P=25). Genotypic resistance to nucleoside reverse transcriptase inhibitors (NRTIs) initially decreased and then returned to prior levels (P=007 for test of homogeneity). Genotypic resistance to 2 or more classes of drugs increased from 1 (2.5%) to 12 (13.2%) (P=004), but only 1 infection (1.2%) in the latter period was resistant to all 3 classes of agents (P=58). Primary phenotypic resistance decreased for NRTIs from 21% to 6.2% (P=03) and increased for NNRTIs from 0 to 8 (9.9%) (P=02). Phenotypic resistance increased for protease inhibitors from 2.6% to 6.2% (P=32). Median time to virologic suppression (
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