Waters Laura, Nelson Mark, Mandalia Sundhiya, Bower Mark, Powles Tom, Gazzard Brian, Stebbing Justin
Department of HIV Medicine, Chelsea and Westminster Hospital and Imperial College School of Medicine, London, United Kingdom.
Clin Infect Dis. 2008 Jan 1;46(1):96-100. doi: 10.1086/523001.
The L74V and K65R mutations confer resistance to several nucleoside analogues, and the impact on subsequent regimens is unclear. The risk of developing L74V or K65R mutation in the era of highly active antiretroviral therapy (HAART) was 4.5 and 2.8 cases per 100 person-years, respectively; concomitant receipt of boosted protease inhibitors protected against K65R. High rates of virologic suppression in the presence of either mutation were observed if the next regimen contained at least 2 active agents. If suboptimal HAART was used, patients with K65R experienced significantly higher rates of virologic suppression than did those with L74V (P = .01).
L74V和K65R突变赋予对多种核苷类似物的耐药性，对后续治疗方案的影响尚不清楚。在高效抗逆转录病毒治疗（HAART）时代，发生L74V或K65R突变的风险分别为每100人年4.5例和2.8例；同时接受增强型蛋白酶抑制剂可预防K65R。如果下一治疗方案至少包含2种活性药物，则在存在任何一种突变的情况下均观察到高病毒学抑制率。如果使用了次优的HAART，K65R患者的病毒学抑制率显著高于L74V患者（P = 0.01）。
