Presentation Abstract

Session: 100-HIV-1 Drug Resistance
Sunday, Sep 18, 2011, 11:15 AM - 1:15 PM
Presentation Title: H2-795 - Drastic Reduction in the Prevalence of RT Mutations in HIV Antiretroviral-Experienced Patients After 2006 in Spain
Location: Exhibit Hall F1
Poster Board Number: 285
Presentation Number: H2-795
Pres. Time: Sunday, Sep 18, 2011, 11:15 AM - 1:15 PM
Category: H2
Keywords: drug resistance mutations; HIV-1; antirretroviral experienced patients
Author(s): L. Anta, PhD - Investigator, A. Corral - Investigator, J. González-Lahoz - Chief Department, V. Soriano - Investigator, C. De Mendoza - Investigator;
Hosp. Carlos III, Madrid, Spain.
Financial Disclosures:  L. Anta, None..
A. Corral, None..
J. González-Lahoz, None..
V. Soriano, None..
C. de Mendoza, None.
Abstract: Background: The availability of new antiretroviral (AR) drugs has modified the HIV treatment guidelines. Changes in the AR combinations prescribed over time may reflect differences in the prevalence of drug resistance mutations. Methods: All resistance tests performed from January 2000 to March 2011 on AR-experienced individuals at Hospital Carlos III in Madrid were examined. Only mutations associated with drug resistance recorded at the December 2010 IAS-USA list were considered. Results: A total of 3800 genotypes from 2721 different HIV-1 individuals were analysed. The overall prevalence of RT drug resistance mutations was significantly lower before and after 2006: M41L (35.5 vs 18.1%), K65R (3.8 vs 2.5%), D67EGN (33.1 vs 18.1%), K70R (18.1 vs 10.9%) L74V (10.6 vs 4.7%), K103N (30.6 vs 18.4%), V106A (2.1 vs 0.5%), Y181C (13.8 vs 8.5%), M184V (39.1 vs 29.6%), L210W (24.9 vs 11.2%), T215FY (42.5 vs 21.1%) and K219ENQ (22 vs 14.1%). Likewise, patients failing a TDF containing regimen showing a lower prevalence in the rate of the resistance patterns to TDF after 2006: K65R (11.5 vs 4.6%, p<0.001), M41L (41.1 vs 20.1%, p<0.0001) and L210W (29.5 vs 11.6%, p<0.0001). For 3TC or FTC, M184V significantly decreased after 2006 (68 vs 53.3%, p<0.0001 and 56 vs 33.3%, p=0.029, respectively). For EFV, K103N (56.4 vs 45.7%, p=0.009), V106AM (4.3 vs 1.2%, p<0.05), Y181C (11.8 vs 5.5%, p=0.007) and G190A (19 vs 7.8%, p<0.0001). For AZT, T215FY (37.6 vs 29.7%, p=0.021), M41L (33 vs 23.3%, p=0.002) and L210W (22.6 vs 13.6%, p=0.001). For ABC, L74IV (18.4 vs 10.8, p=0.003), whereas K65R did not differ significantly. The depletion in the rate of these resistance patterns was independently associated with the proportion of patients taking the specific drug and/or their length of previous exposure. Conclusions: A great decline in the overall prevalence of RT-resistance mutations in patients failing AR therapy has been observed after 2006, regardless to treatment exposure. This could be attributed to the increase in the use of new compounds, which are more powerful, and co-formulated drugs, which are more convenient.




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