Document Detail

Predicted susceptibility of etravirine in HIV patients experiencing virological failure secondary to non-nucleoside reverse transcriptase inhibitor resistance in Argentina.
MedLine Citation:
PMID:  21592625     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Virological response to etravirine (ETR) is dependent on the type and number of non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance-associated mutations (RAMs).
METHODS: Data on NNRTI used in HAART at the time of failure and the number of NNRTI-RAMs were collected and retrospectively analyzed. ETR-RAMs were defined as V90I, A98G, L100I, K101E/H/P, V106I, E138A, V179D/F/T, Y181C/I/V, G190A/S, and M230L, and were analyzed according to the weighted mutation score to predict susceptibility (Vingerhoets 2008).
RESULTS: N=150. Efavirenz (EFV) containing regimen: 76.7%; nevirapine (NVP): 23.3%. Frequency of ETR-RAMs acquired after NNRTI failure: zero=38.7%, one=39.3%, two=17.3%, three=3.3%, four=1.3%. Most frequent ETR-RAMs after failure with EFV: G190A (28.1%), K101E (14.9%), L100I (10.5%); and with NVP: Y181C (41.7%), G190A (30.6%) and A98G (13.9%). Global predicted susceptibility of ETR: highest response: 69.3%, intermediate response: 24.7%, reduced response: 6%. Comparing maximal response with duration of virological failure: EFV-containing regimen: 94.4% (< 24-weeks) vs. 69.8% (>24-weeks) (p=0.02); NVP-containing regimen: 42.9% (< 24-weeks) vs. 56.5% (>24-weeks) (p=0.41). The presence of lamivudine regimen was associated with a better predicted susceptibility (highest response) to ETR (79% vs. 25%; P=.001).
DISCUSSION: The majority of patients maintained susceptibility to ETR after the acquisition of NNRTI resistance. Failing with an EFV-containing regimen had a better predicted susceptibility to ETR than with NVP, especially after short-term virological failure.
Ezequiel Córdova; Eliana Loiza; Norma Porteiro; Horacio Mingrone
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Publication Detail:
Type:  Journal Article     Date:  2011-05-17
Journal Detail:
Title:  Enfermedades infecciosas y microbiología clínica     Volume:  29     ISSN:  1578-1852     ISO Abbreviation:  Enferm. Infecc. Microbiol. Clin.     Publication Date:    2011 Jun-Jul
Date Detail:
Created Date:  2011-06-20     Completed Date:  2011-11-28     Revised Date:  2013-08-26    
Medline Journal Info:
Nlm Unique ID:  9104081     Medline TA:  Enferm Infecc Microbiol Clin     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  428-31     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier España, S.L. All rights reserved.
Hospital Francisco J. Muñiz, Outpatient Care Department, Buenos Aires, Argentina, IDEAA Foundation, Buenos Aires, Argentina.
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MeSH Terms
Drug Resistance, Viral
HIV / drug effects,  genetics
HIV Infections / drug therapy*
Middle Aged
Pyridazines / pharmacology,  therapeutic use*
Retrospective Studies
Reverse Transcriptase Inhibitors / pharmacology,  therapeutic use
Young Adult
Reg. No./Substance:
0/Pyridazines; 0/Reverse Transcriptase Inhibitors; 0C50HW4FO1/etravirine

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