Open AccessFrequency of Genotypic and Phenotypic Drug-Resistant HIV-1 Among Therapy-Naive Patients of the German Seroconverter Study
Author(s) -
Susanne Duwe,
Monika Brunn,
Doris Altmann,
Osamah Hamouda,
Bárbara Schmidt,
Hauke Walter,
Georg Pauli,
Claudia Kücherer
Publication year - 2001
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/00042560-200103010-00010
Subject(s) - virology , reverse transcriptase , genotype , drug resistance , seroconversion , biology , reverse transcriptase inhibitor , nucleoside reverse transcriptase inhibitor , lentivirus , transmission (telecommunications) , viral load , virus , medicine , viral disease , antiretroviral therapy , polymerase chain reaction , genetics , gene , electrical engineering , engineering
Genotypic and phenotypic resistance of viral reverse transcriptase (RT) and protease (PR) was determined for 64 therapy-naive, HIV-1-infected seroconverters of the German Seroconverter Study coordinated by the Robert Koch-Institut, Berlin. The date of seroconversion of patients and the laboratory, clinical, and therapeutic follow-up data were documented. Samples were collected between 1996 and 1999. Phenotypic resistant HIV-1 were found in 8 (13%) seroconverters; in most cases resistance was weak and mainly directed against RT inhibitors (4 nucleoside reverse transcriptase inhibitors [NRTIs], 2 nonnucleoside reverse transcriptase inhibitors [NNRTIs], 1 combination NRTI/NNRTI). Only one infection with a weak PR inhibitor resistance was identified. Transmission of multidrug-resistant HIV-1 has not yet been observed. Frequently at least one or more amino acid mutations associated with antiretroviral drug resistance were detected by genotypic analysis. The mean number of resistance-associated mutations in the RT of the transmitted virus has increased significantly since 1996. Studies have shown the improved benefit of initial antiretroviral therapy if based on genotypic resistance data. In view of the considerably high level of transmission of resistant HIV-1 in Germany, which is also seen in other studies in Europe and the United States, we suggest determining the genotypic resistance pattern before starting therapy of newly HIV-1-infected patients.