SZU-MIN HSIEHSUI-YUAN CHANGCHIEN-CHING HUNGWANG-HUEI SHENGChen M.-Y.SHAN-CHWEN CHANG2020-06-182020-06-1820091471-2334https://scholars.lib.ntu.edu.tw/handle/123456789/503556Background: 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.[SDGs]SDG3atazanavir; 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 Adultjournal article10.1186/1471-2334-9-154197515022-s2.0-70349970704