No pol mutation is associated independently with the lack of immune recovery in patients infected with HIV and failing antiretroviral therapy

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RESEARCH PRODUCT

No pol mutation is associated independently with the lack of immune recovery in patients infected with HIV and failing antiretroviral therapy

N1 Gianotti L Galli M Zazzi V Ghisetti S Bonora V Micheli P Meraviglia P Corsi B Bruzzone S Menzo S Di Giambenedetto A De Luca G Filice G Penco A Castagna Arca Database I. N. I. T. I. A. T. I. V. E. Collaborators Giacometti A L Butini R Del Gobbo S Menzo D Tacconi G Corbelli S Zanussi L Monno G Punzi F Maggiolo A Callegaro L Calza Mc Re R Pristerà P Turconi A Mandas S Tini G Carnevale E Paolini G Amadio L Sighinolfi G Zuccati M Morfini R Manetti P Corsi L Galli M Di Pietro F Bartalesi G Colao A Tosti A Di Biagio M Setti B Bruzzone G Penco M Trezzi A Orani R Pardelli M De Gennaro A Chiodera A Scalzini L Palvarini P Almi G Todaro N Gianotti P Cicconi S Rusconi Mr Gismondo V Micheli Ml Biondi N Gianotti A Capetti P Meraviglia E Boeri M Pecorari C Mussini M Santirocchi D Brustia P Ravanini F Dal Bello N Romano S Mancuso C Calzetti R Maserati G Filice F Baldanti D Francisci G Parruti E Polilli D Sacchini C Martinelli R Consolini L Vatteroni A Vivarelli A Nerli L Lenzi G Magnani P Ortolani M Andreoni G Palamara C Fimiani L Palmisano A De Luca S Di Giambenedetto A Antinori Vincenzo Vullo O Turriziani Cf Perno M Montano G Cenderello A Gonnelli L Romano M Palumbo V Ghisetti S Bonora P Delle Foglie C Rossi F Poletti V Mondino M Malena E. Lattuada

subject

Male HIV Infections Drug resistance Logistic regression Resistance to nucleoside reverse transcriptase inhibitor CD4+ T-lymphocyte Retrospective Studie Immunopathology Antiretroviral Therapy Highly Active Resistance to non-nucleoside reverse transcriptase inhibitor genetics Resistance to protease inhibitor HIV Infection resistance to nucleoside reverse transcriptase inhibitors Viral Sida resistance to protease inhibitors biology Reverse-transcriptase inhibitor Viral Load Genes pol drug therapy/immunology/virology Reverse Transcriptase Inhibitor Infectious Diseases Treatment Outcome resistance to non-nucleoside reverse transcriptase inhibitors Reverse Transcriptase Inhibitors Female Viral load medicine.drug Human pol Anti-HIV Agents Antiretroviral Therapy Viremia Infectious Disease Settore MED/17 - MALATTIE INFETTIVE pharmacology/therapeutic use Acquired immunodeficiency syndrome (AIDS)Virology Drug Resistance Viral medicine Humans Highly Active Retrospective Studies Anti-HIV Agents; pharmacology/therapeutic use Antiretroviral Therapy; Highly Active CD4 Lymphocyte Count Drug Resistance; Viral; genetics Female Genes; pol HIV Infections; drug therapy/immunology/virology HIV-1; drug effects/enzymology/genetics Humans Male Mutation Retrospective Studies Reverse Transcriptase Inhibitors; therapeutic use Treatment Outcome Viral Load drug resistance Anti-HIV Agent biology.organism_classification medicine.disease Virology CD4 Lymphocyte Count Genes drug effects/enzymology/genetics therapeutic use Mutation CD4+ T-lymphocytes HIV-1

description

An investigation was undertaken to determine whether specific pol mutations hinder long-term immune recovery regardless of virological response. In total, 826 patients with >50 HIV RNA copies/ml, who underwent genotypic resistance testing between 1 January 2000 and 31 December 2003 after >3 years of antiretroviral treatment, and were followed up for >3 years after genotypic resistance testing, were analyzed retrospectively. The outcome of the study was the lack of immune recovery after >3 years of follow-up, defined as a slope by linear regression 50 copies/ml divided by the number of HIV RNA measurements during follow-up. Logistic regression was used for univariable and multivariable analysis. Median (Q1, Q3) values at baseline were the following: age 40 (37, 45) years, years on antiretroviral therapy 4.45 (3.65, 5.47), HIV RNA 3.91 (3.39, 4.53) log 10 copies/ml, CD4+ T-cell 358 (211, 524)/μl. After 3.13 years of follow-up, 375 patients (45.4%) showed a lack of immune recovery. The risk of lack of immune recovery increased independently with increasing baseline CD4+ counts (OR=1.104 per 50-cell increase, 95% CI=1.069-1.142, P<0.0001), increasing viremia detectability ratio during follow-up (OR=1.145 per 0.1-unit increase, 95% CI=1.093-1.202, P<0.0001), and with earlier calendar years of resistance testing (overall effect: P=0.0007). In conclusion, no pol mutation is associated independently with the lack of immune recovery. J. Med. Virol. 83:391-398, 2011. © 2011 Wiley-Liss, Inc.

year	journal	country	edition	language
2011-01-01

http://hdl.handle.net/10807/6024