Fernández Lisón L C, Fernández Pereira L M, Romero Chala S
Servicio de Farmacia Hospitalaria, Complejo Hospitalario de Cáceres, Cáceres, España.
Farm Hosp. 2011 Jul-Aug;35(4):191-6. doi: 10.1016/j.farma.2010.05.008. Epub 2010 Nov 18.
The objective is to describe the resistance mutation rate in protease and reverse transcriptase genes and sensitivity to different antiretrovirals in our environment.
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(®).
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.
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.
目的是描述我们研究环境中蛋白酶和逆转录酶基因的耐药突变率以及对不同抗逆转录病毒药物的敏感性。
我们进行了一项观察性描述性研究，检查了2004年4月至2009年4月临床免疫实验室提供的样本。我们使用trugene hiv01基因分型试剂盒（®）分析了治疗失败患者的耐药性测试和对不同药物的敏感性。
我们登记了242例患者的样本，其中61例未检测到耐药性。根据药物类别，最常见的突变是：核苷类逆转录酶抑制剂的T215A/C/D/F/L/N/S/Y（24.10%）、M184G/I/V/W（14.66%）、M41J/L/R/T/W（11.24%）和K219E/G/H/N/R/T/W（10.24%）。耐药水平最高的是司他夫定和拉米夫定/恩曲他滨，在我们的研究环境中，替诺福韦产生的耐药性最低。非核苷类的是K103N/R（23.98%）、V179D/E/I/M/T（10.82%）、A98E/G/S（10.53%）和K101E/P/Q/R（9.06%）。奈韦拉平的耐药性高于依非韦伦。蛋白酶抑制剂为L10F/I/V（15.95%）、M36I/L（13.81%）、A71I/T/V（13.10%）和154L/S/V（7.38%）。达芦那韦/利托那韦组合的耐药性最低，替拉那韦/利托那韦和洛匹那韦/利托那韦的耐药性最高。
我们研究环境中抗逆转录病毒药物的耐药性和对逆转录病毒治疗的敏感性与西班牙其他研究结果相似，但对拉米夫定/恩曲他滨和洛匹那韦/利托那韦的高耐药水平有所不同。
