HIV-1 Protease Inhibitors Resistance Profiles in Patients with Virological Failure on LPV/r-based 2nd Line Regimen in Cambodia
- *Corresponding Author:
- Eric Nerrienet, Ph.D
Institut Pasteur de Paris
Unité RIR, 25 rue du Dr Roux
75 045, Paris, France
Email: [email protected]
Received Date: May 16, 2012; Accepted Date: June 18, 2012; Published Date: June 20, 2012
Citation: Nerrienet E, Nouhin J, Ngin S, Segeral O, Ken S, et al. (2012) HIV-1 Protease Inhibitors Resistance Profiles in Patients with Virological Failure on LPV/r-based 2nd Line Regimen in Cambodia. J AIDS Clinic Res S5:003. doi:10.4172/2155-6113.S5-003
Copyright: © 2012 Nerrienet E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credit ed.
Objective: To describe the ARV resistance profiles of patients experiencing virological failure after at least 6 months on LPV/r-based 2nd line regimen in Cambodia. Design: Retrospective analysis of resistance testing of 89 patients with detectable viral load under LPV/r-based 2nd line regimen.
Methods: Bulk sequencing of HIV-1 protease, reverse transcriptase and integrase PCR products.
Results: Protease gene amplification was successful for 71/89 patients (80%). All were infected by CRF01_AE viruses. Among them, 42 did not present any resistance to PIs. A high level of resistance to PIs was observed for the 29 remaining patients. Twenty-six were resistant to LPV/r (8 possibly resistant). Twenty-eight, 21 and 20 were also found resistant to IDV, ATV/r and FPV/r, respectively. Twenty-six were resistant to NFV (11 possibly) and 22 to SQV/r (9 possibly). Finally, 22/29 (75.8%) were resistant to at least 3 PIs. Interestingly, 78.6% (22/29) were found sensitive to DRV/r. In this group, a high frequency of resistance to RTIs including ETV was also reported. No resistance to raltegravir (RAL) or elvitegravir (EVG) was observed (n=24). Detailed ARV histories documented for 15 patients revealed past exposition to multiple RTIs and PIs.
Conclusion: Almost 2/3 of patients (60/89) with virological failure on LPV/r-based 2nd line in our study were not in urgent need for treatment change. In contrast, switching treatment was clearly required for 1/3 (29/89) presenting high level of resistance to PIs and RTIs. For those patients, DRV, RAL/EVG, and potentially ETV, could be good candidates for 3rd line ARV regimen if available.