Schapiro J M, Lawrence J, Speck R, Winters M A, Efron B, Coombs R W, Collier A C, Merigan T C
Division of Infectious Diseases, Stanford University School of Medicine, California, USA.
J Infect Dis. 1999 Jan;179(1):249-53. doi: 10.1086/314541.
The relationships among treatment regimens, plasma human immunodeficiency virus (HIV) RNA levels, and resistance mutations to saquinavir (codons 48 and 90) and zidovudine (codon 215) were examined in a cohort of 144 patients from the AIDS Clinical Trials Group 229 study. After 24-40 weeks of therapy, no patients who had received the two-drug combination (zidovudine plus saquinavir) had only codon 48 mutations, 45.8% had only codon 90 mutations, and 8.3% had both codon 48 and 90 mutations. Mutations developed by patients who had received the three-drug combination (zidovudine and zalcitabine plus saquinavir) were codon 48 alone in 1.4%, codon 90 alone in 33.3%, and both codons 48 and 90 in 4.2%. The difference between the groups showed a trend toward reduced mutations with three versus two drugs but did not reach significance (P=.11, two-sided chi2). Higher baseline HIV RNA levels correlated with the development of protease mutations. Mutations at codon 215 were present in 82% of all patients at baseline and in 87% after therapy.
在艾滋病临床试验组229研究的144名患者队列中，研究了治疗方案、血浆人类免疫缺陷病毒（HIV）RNA水平以及对沙奎那韦（密码子48和90）和齐多夫定（密码子215）的耐药突变之间的关系。治疗24 - 40周后，接受两药联合治疗（齐多夫定加沙奎那韦）的患者中，没有患者仅出现密码子48突变，45.8%的患者仅出现密码子90突变，8.3%的患者同时出现密码子48和90突变。接受三药联合治疗（齐多夫定、扎西他滨加沙奎那韦）的患者中，仅出现密码子48突变的占1.4%，仅出现密码子90突变的占33.3%，同时出现密码子48和90突变的占4.2%。两组之间的差异显示出三药治疗与两药治疗相比突变有减少的趋势，但未达到显著水平（P = 0.11，双侧卡方检验）。较高的基线HIV RNA水平与蛋白酶突变的发生相关。密码子215处的突变在所有患者基线时的发生率为82%，治疗后的发生率为87%。
