https://scholars.lib.ntu.edu.tw/handle/123456789/503556
標題: | Impact of first-line protease inhibitors on predicted resistance to tipranavir in HIV-1-infected patients with virological failure | 作者: | SZU-MIN HSIEH SUI-YUAN CHANG CHIEN-CHING HUNG WANG-HUEI SHENG Chen M.-Y. SHAN-CHWEN CHANG |
公開日期: | 2009 | 卷: | 9 | 起(迄)頁: | 154 | 來源出版物: | BMC Infectious Diseases | 摘要: | Background: Tipranavir (TPV) is a recently approved nonpeptidic protease inhibitor (PI) of HIV-1 and has been indicated for those infected with PIs-resistant HIV-1. However, in clinical practice, whether the HIV-1 from the patients with virological failure to the regimens containing first-line PIs remains susceptible to TPV/r may be questionable. Methods: To assess the resistance levels to TPV of HIV-1 from patients with treatment failure to first-line PIs, patients who experienced virological failure were tested for genotypic resistance of HIV-1 since August 2006 in National Taiwan University Hospital. Patients were enrolled for this analysis if their failed regimens contained > 12 weeks of atazanavir or lopinavir/ritonavir (defined as ATV group and LPV/r group, respectively), but were excluded if they experienced both or other PIs. The levels of genotypic resistance to TPV/r were determined by TPV mutation score. Results: Till May 2008, 21 subjects in ATV group and 20 subjects in LPV/r group were enrolled. The TPV mutation scores in subjects in LPV/r group were significantly higher than these in ATV group (median, 3 vs 1, P = 0.007). 95.2% subjects in ATV group and only 45% subjects in LPV/r group had an estimated maximal virological response to TPV/r (P < 0.001). The resistance levels to TPV/r correlated with the duration of exposure to first-line PIs, whether in ATV or LPV/r group. Conclusion: Cross-resistance from first-line PIs may impede the effectiveness of TPV/r-containing salvage therapy. TPV/r should be used cautiously for patients with virological failure to LPV/r especially long duration of exposure. ? 2009 Hsieh et al; licensee BioMed Central Ltd. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/503556 | ISSN: | 1471-2334 | DOI: | 10.1186/1471-2334-9-154 | SDG/關鍵字: | atazanavir; lopinavir plus ritonavir; proteinase inhibitor; RNA directed DNA polymerase inhibitor; tipranavir; adult; antiviral resistance; article; clinical article; controlled study; cross resistance; drug efficacy; drug response; drug treatment failure; female; genetic susceptibility; genotype; human; Human immunodeficiency virus 1 infection; Human immunodeficiency virus infected patient; male; salvage therapy; Taiwan; treatment duration; virus mutation; Adult; DNA Mutational Analysis; Drug Resistance, Viral; Female; HIV Infections; HIV Protease Inhibitors; HIV-1; Humans; Male; Middle Aged; Oligopeptides; Pyridines; Pyrimidinones; Pyrones; Ritonavir; RNA, Viral; Treatment Failure; Young Adult |
顯示於: | 醫學檢驗暨生物技術學系 |
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