Thymidine-analog and Multi-nucleoside resistance Mutations Are Observed in Both Zidovudine-naive and Zidovudine-experienced Subjects With Viremia After Treatment With Stavudine-containing Regimens

摘要

ObjectiveThe type and frequency of mutations in the human immunodeficiency virus type 1 (HIV-1) reverse transcriptase coding region observed in virus from antiretroviral therapy (ART)-experienced, zidovudine (ZDV)-naive subjects receiving stavudine (d4T)-based therapies were compared with mutations observed in virus from ART-experienced subjects with previous ZDV exposure.MethodsPlasma HIV-1 RNA was isolated from 67 ART-experienced subjects. Reverse transcriptase mutations were assessed by sequencing polymerase chain reaction products.ResultsThirty-four subjects (51percnt;) were ZDV-experienced (Zexp) and 33 (49percnt;) were ZDV-naive and d4T-experienced (dexpZnaive). Human immunodeficiency virus type 1 from 16 of 33 (48percnt;) dexpZnaivesubjects and from 16 of 34 (47percnt;) Zexpsubjects had thymidine analog mutations (TAMs). Multi-nucleoside resistance (MNR) mutations were observed in virus from 5 of 33 (15percnt;) dexpZnaivesubjects and 3 of 34 (9percnt;) Zexpsubjects. At least one TAM or MNR mutation was identified in 18 of 33 (55percnt;) of the former and in 19 of 34 (56percnt;) of the latter group.ConclusionsThese results confirm recent reports that TAMs and MNR mutations can arise in subjects receiving d4T-based therapy who are naive with respect to ZDV.