Balduin Melanie, Oette Mark, Däumer Martin P, Hoffmann Daniel, Pfister Herbert J, Kaiser Rolf
Institute of Virology, University of Cologne, Cologne, Germany.
J Clin Virol. 2009 May;45(1):34-8. doi: 10.1016/j.jcv.2009.03.002. Epub 2009 Apr 17.
Minority HIV-1 populations with resistance mutations might result in therapy failure. The prevalence of transmitted minorities in therapy-naïve patients and their influence on the virological outcome of the first-line-therapy need clarification.
The HIV reverse transcriptase (RT) of 159 therapy-naïve patients from the RESINA-cohort was genotyped. The relative amount of RT-K103N was measured by primer specific PCR. The response to first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-therapy was evaluated.
Bulk-sequencing detected 1 NNRTI mutation (no K103N) in six patients (1.26%). K103N minorities were found in 20.1% of the samples, more frequently in HIV-1 non-B subtypes (40.6%) than in subtype B (15.0%) (p=0.0025). NNRTI treatment failed after 12 weeks in 24% of 17 patients with minority, but only in 15% of 67 patients without minority.
K103N minorities were found in 20.1% of the patients, whereas the prevalence of major K103N populations was 3% in the total RESINA-cohort. K103N minorities were more frequent in non-B subtypes. There is some evidence for a higher risk of NNRTI-treatment failure in patients with K103N minorities; however, the majority of patients with minority underwent a successful first-line-treatment.
携带耐药突变的少数族裔HIV-1人群可能导致治疗失败。初治患者中传播性少数族裔的患病率及其对一线治疗病毒学结果的影响尚需阐明。
对RESINA队列中159例初治患者的HIV逆转录酶（RT）进行基因分型。通过引物特异性PCR测定RT-K103N的相对含量。评估对一线非核苷类逆转录酶抑制剂（NNRTI）治疗的反应。
高通量测序在6例患者（1.26%）中检测到1个NNRTI突变（无K103N）。在20.1%的样本中发现了K103N少数群体，在HIV-1非B亚型中（40.6%）比在B亚型中（15.0%）更常见（p = 0.0025）。17例有少数群体的患者中，24%在12周后NNRTI治疗失败，但在67例无少数群体的患者中仅15%治疗失败。
在20.1%的患者中发现了K103N少数群体，而在整个RESINA队列中主要K103N群体的患病率为3%。K103N少数群体在非B亚型中更常见。有一些证据表明，K103N少数群体患者接受NNRTI治疗失败的风险更高；然而，大多数有少数群体的患者一线治疗成功。
