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Identification of key mutations in HIV reverse transcriptase gene can influence the clinical outcome of HAART
Author(s) -
Setti Maurizio,
Bruzzone Bianca,
Ansaldi Filippo,
Borrelli Paolo,
Indiveri Francesco,
Icardi Giancarlo
Publication year - 2001
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.1037
Subject(s) - reverse transcriptase , genotype , drug resistance , mutant , mutation , virology , clinical significance , human immunodeficiency virus (hiv) , medicine , gene , lentivirus , biology , viral disease , polymerase chain reaction , genetics
Therapeutic failures due to in vivo loss of drug sensitivity are still a major problem in AIDS care. Currently, the role of and methods for detecting resistant mutant strains in patients before therapeutic choices are still under debate. To investigate the relevance of screening for key mutations alone the commercial INNO‐LiPA HIV‐1 RT method was applied retrospectively to analyzing several HIV codons correlated with resistance to RTI (reverse‐transcriptase inhibitors) in sera from 62 patients before starting HAART protocols, selected on the basis of clinical parameters. INNO‐LiPA detected several resistant mutant strains, which were strictly consistent with previous selective pressure in the patients. A significant correlation between genotype pattern and response to HAART was found. The presence of key mutations associated with resistance to one or two RTI included in the protocol correlated with a decrease in treatment benefits, whereas patients with wild‐type or non‐resistant viral strains exhibited better response to HAART. Even if this information had been available when treatment was started, 45 of the patients would not have received different treatment. When compared with the total number of patients, the subgroup receiving a treatment that was considered retrospectively as consistent with the key mutation pattern exhibited a significantly better outcome. Although the interpretation of resistance‐related key mutations needs improvement, this surrogate LiPA method seems to maintain a predictive role in the management of HIV infection, and is less expensive. J. Med. Virol. 64:199–206, 2001. © 2001 Wiley‐Liss, Inc.