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Monitoring the emergence of resistance mutations in patients infected with HIV‐1 under salvage therapy with raltegravir in Rio de Janeiro, Brazil: A follow‐up study
Author(s) -
Passaes Caroline Pereira Bittencourt,
Guimarães Monick Lindenmeyer,
Cardoso Sandra Wagner,
Pilotto José Henrique,
Veloso Valdilea,
Grinsztejn Beatriz,
Morgado Mariza Gonçalves
Publication year - 2012
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.23409
Subject(s) - raltegravir , virology , salvage therapy , human immunodeficiency virus (hiv) , antiretroviral therapy , biology , medicine , genetics , viral load , chemotherapy
The present study describes a follow‐up of a prospective and observational cohort of patients infected with HIV‐1 and treated with raltegravir for salvage therapy in Brazil. Two groups of patients were analyzed: switching from T20 to RAL (Group 1, n = 9) and salvage therapy containing RAL (Group 2, n = 10). Blood samples were drawn for CD4 + T‐cell counts and HIV‐1 viral load determinations. Protease, reverse transcriptase, and integrase genotyping were performed at baseline and at the time of virologic failure. CD4 + T‐cells increased at 6 and 12 months in both groups; HIV‐1 viral load was continuously suppressed for Group 1, and for Group 2 it significantly decreased after starting a RAL‐containing regimen. Three out of 10 patients from Group 2 could not suppress HIV‐1 viral load. The mutations Q148H + G140S were observed for two patients and for the third patient only mutations to PR/RT inhibitors were detected. The genotypic sensitivity score (GSS) was analyzed for all patients of Group 2 and both patients who developed resistance to raltegravir presented a GSS < 2.0 for the RAL‐containing scheme, which could be associated to the lack of effectiveness of the proposed scheme. The present study describes, for the first time in Brazil, the close follow‐up of a series of patients using a raltegravir‐containing HAART, showing the safety of the enfuvirtide switch to RAL and the effectiveness of a therapeutic regimen with RAL in promoting immune reconstitution and suppressing HIV replication, as well as documenting the occurrence of resistance to integrase inhibitors in the country. J. Med. Virol. 84:1869–1875, 2012. © 2012 Wiley Periodicals, Inc.