ABSTRACT ARCHIVE

Mutations of multiresistance associated to the use of nucleoside/nucleotide reverse transcriptase inhibitors in Western México

Background: The reverse transcriptase is a major target for antiretroviral intervention and the TAMs are the main source of multi-nRTI resistance. The objective was to associate the frequency of TAMs with nRTIs utilized in HIV/AIDS patients from Western Mexico.
Methods: During 2002 to 2004, 92 patients with HIV/AIDS from 4 medical centers, ³18 years old, antiretroviral (ARV) therapy ³1 year, viral load ³5000 copies/mL and CD4 count £500 cells/µl. were studied. RT gene (codons 37-248) was sequenced using TruGene HIV-1 Genotyping Kit. ARV drug resistance was obtained using Stanford software (http://hivdb.stanford.edu). TAMs were associated with the drug resistance to: Zidovudine (Azt), Lamivudine (3tC), Zalcitabine (ddC), Didanosine (ddI), Stavudina (d4T), Abacavir (ABC), using the odds ratios (OR), with an interval of confidence of 95% and a level of significance of p£0.05 (SPSS 13).
Results: Eighty two (89.1%) men and 10 (10.9%) women were studied, CD4 and viral load mean ± sd were 208.7 ± 238.5 cells/µL and 245,707 ± 280,378 copies/mL respectively. TAMs and nRTIs were found as follow (n= treatment-patiens/total of patients): M41L (OR 2.49, IC95% 0.29-21.3), D67N (1.47 IC95% 1.27-1.7), M184V (1.33 IC95% 1.17-1.51) and L210W (1.33 IC95% 1.17-1.51) to Azt (n=84/92); M41L (3.23 IC95% 1.25-8.84), V118I (3.29 IC95% 1.05-9.8), L210W (3.39 IC95% 1.23-9.32) and T215Y (3.75 IC95% 1.5-9.16) to ddC (n=36/92); D67N (2.03 IC95% 0.75-5.48), T215Y (1.37 IC95% 0.56-3.35) and K219Q (1.16 IC95% 1.05-1.29) to ddI (n=58/92); M184V (5.16 IC95% 1.11-23.99) to 3tC (n=65/92); L210W (2.77 IC95% 0.84-9.8) and T215Y (1.47 IC95% 0.59-3.64) to d4T (n=60/92); L210W (3.10 IC95% 0.75-12.8) and D67N (2.08 IC95% 0.5-8.46) to ABC (n=9/92).
Conclusions: In Western Mexico, the risk association of TAMs with antiretrovirals are in importance as follow: ddC, Azt, ddI, d4T and ABC.