학술논문

Variability in the Interpretation of Transmitted Genotypic HIV-1 Drug Resistance and Prediction of Virological Outcomes of the Initial Haart by Distinct Systems
Document Type
Article
Author
Luca, Andrea DeCozzi-Lepri, AlessandroPerno, Carlo-FedericoBalotta, ClaudiaGiambenedetto, Simona DiPoggio, AntonioPagano, GabriellaTositti, GiuliaPiscopo, RitaForno, Antonio DelChiodo, FrancescoMagnani, GiacomoMonforte, Antonella d'ArminioAngarano, GAntinori, ABalotta, CCozzi-Lepri, AMonforte, A d'ArminioDe Luca, AMonno, LPerno, CFRusconi, SMontroni, MScalise, GZoli, ADel Prete, MSTirelli, UDi Gennaro, GPastore, GLadisa, NMinafra, GSuter, FArici, CChiodo, FColangeli, VFiorini, CCoronado, OCarosi, GCadeo, GPCastelli, FMinardi, CVangi, DRizzardini, GMigliorino, GManconi, PEPiano, PFerraro, TScerbo, APizzigallo, ED'Alessandro, MSantoro, DPusterla, LCarnevale, GGalloni, DViganò, PMena, MGhinelli, FSighinolfi, LLeoncini, FMazzotta, FPozzi, MCaputo, S LoAngarano, GGrisorio, BFerrara, SGrima, PTundo, PPagano, GPiersantelli, NAlessandrini, APiscopo, RToti, MChigiotti, SSoscia, FTacconi, LOrani, APerini, PScasso, AVincenti, AChiodera, FCastelli, PScalzini, AFibbia, GMoroni, MLazzarin, ACargnel, AVigevani, GMCaggese, Ld'Arminio Monforte, ARepetto, DNovati, RGalli, AMerli, SPastecchia, CMoioli, MCEsposito, RMussini, CAbrescia, NChirianni, AIzzo, CPiazza, MDe Marco, MMontesarchio, VManzillo, EGraf, MColomba, AAbbadessa, VPrestileo, TMancuso, SFerrari, CPizzaferri, PFilice, GMinoli, LBruno, RNovati, SBalzelli, FLoso, KPetrelli, ECioppi, AAlberici, FRuggieri, AMenichetti, FMartinelli, CDe Stefano, CGala, A LaBallardini, GBriganti, EMagnani, GUrsitti, MAArlotti, MOrtolani, PCauda, RDianzani, FIppolito, GAntinori, AAntonucci, GD'Elia, SNarciso, PPetrosillo, NVullo, VDe Luca, ADi Giambenedetto, SZaccarelli, MAcinapura, RDe Longis, PCiardi, MD'Offizi, GTrotta, MPNoto, PLichtner, MCapobianchi, MRGirardi, EPezzotti, PRezza, GMura, MSMannazzu, MCaramello, PSinicco, ASoranzo, MLGennero, LSciandra, MBonasso, MGrossi, PABasilico, CPoggio, ABottari, GRaise, EPasquinucci, SDe Lalla, FTositti, GResta, FChimienti, ALepri, A Cozzi
Source
Antiviral Therapy; July 2004, Vol. 9 Issue: 5 p743-752, 10p
Subject
Language
ISSN
13596535
Abstract
High level HIV-1 drug resistance in recently infected treatment-naive individuals correlates with sub-optimal virological responses to highly active antiretroviral therapy (HAART). To determine whether genotypic HIV-1 drug resistance in chronic naive patients, as interpreted by various systems, could predict the virological outcomes of HAART, isolates from patients enrolled in a prospective observational cohort (ICoNA) prior to treatment start were genotyped. Genotypic susceptibility scores (GSS) assigned to the initial HAART regimens using the interpretations of pre-therapy resistance mutations by 13 systems were related to virological outcomes. Of 415 patients, 42 (10%) had at least one major resistance mutation. According to the different interpretations, 1.9–20.5% of patients had some level of resistance to at least one drug in the initial regimen. In multivariable analysis, GSS from two systems significantly predicted the time to virological success: Rega 5.5, for each unit increase in GSS adjusted relative hazard (RH) 1.86 [95% confidence intervals (95% CI): 1.15–3.02] and hivresistanceWeb v3, RH 1.87 (95% CI: 1.00–3.48). With three other systems, GSS showed a trend towards a significant prediction of success: Retrogram 1.6, RH 2.33 (95% CI: 0.98–5.53), Menéndez 2002, RH 2.36 (95% CI: 0.97–5.72) and Stanford hivdb, RH 2.06 (95% CI: 0.94–4.49). Genotypic resistance testing coupled with adequate interpretation in chronic naive patients can usefully identify those at risk of sub-optimal virological response to HAART.