Tasa de mutaciones genotípicas y resistencia a antirretrovirales en un hospital general
2011
Objectives: The objective is to describe the resistance mutation rate in protease and reverse
transcriptase genes and sensitivity to different antiretrovirals in our environment.
Methods: We performed an observational descriptive study in which we examined the samples
provided at the clinical immunology laboratory between April 2004 and April 2009. We analysed
both the resistance tests and the sensitivity to different drugs in patients with therapeutic
failure using trugene hiv01 genotyping kits®.
Results: We registered samples from 242 patients, 61 of which had no detectable resistance.
The most prevalent mutations according to drug families were: for nucleoside analog
reverse transcriptase inhibitors T215A/C/D/F/L/N/S/Y (24.10%), M184G/I/V/W (14.66%),
M41J/L/R/T/W (11.24%) and K219E/G/H/N/R/T/W (10.24%). The highest levels of resistance
corresponded to stavudine and lamivudine/emtricitabine, and tenofovir produced the least
resistance in our environment. The non-analogues were K103N/R (23.98%), V179D/E/I/M/T
(10.82%), A98E/G/S (10.53%) y K101E/P/Q/R (9.06%). Nevirapine presented greater resistance
than efavirenz.
Protease inhibitors were L10F/I/V (15.95%), M36I/L (13.81%), A71I/T/V (13.10%) and 154L/S/V
(7.38%). The combination darunavir/ritonavir combination was that which presented the least
resistance, and tipranavir/ritonavir and lopinavir/ritonavir the most resistance.
Conclusions: Antiretroviral resistance and sensitivity to retroviral treatment in our environment
was similar to results from other studies in Spain, but differed in the high level of resistance to
lamivudine/emtricitabine and lopinavir/ritonavir.
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