Baseline Resistance to Nucleoside Reverse Transcriptase Inhibitors Fails to Predict Virologic Response to Combination Therapy in Children (PACTG 338)

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Baseline Resistance to Nucleoside Reverse Transcriptase Inhibitors Fails to Predict Virologic Response to Combination Therapy in Children (PACTG 338)

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dc.contributor.author Fiscus, Susan A
dc.contributor.author Kovacs, Andrea
dc.contributor.author Petch, Leslie A
dc.contributor.author Hu, Chengcheng
dc.contributor.author Wiznia, Andrew A
dc.contributor.author Mofenson, Lynne M
dc.contributor.author Yogev, Ram
dc.contributor.author Pelton, Stephen I
dc.contributor.author Napravnik, Sonia
dc.contributor.author Nachman, Sharon A
dc.contributor.author McIntosh, Kenneth
dc.contributor.author Stanley, Kenneth Earl
dc.date.accessioned 2012-01-09T01:09:20Z
dc.date.issued 2007
dc.identifier.citation Fiscus, Susan A, Andrea Kovacs, Leslie A Petch, Chengcheng Hu, Andrew A Wiznia, Lynne M Mofenson, Ram Yogev, Kenneth McIntosh, Stephen I Pelton, Sonia Napravnik, Kenneth Stanley, and Sharon A Nachman. 2007. Baseline resistance to nucleoside reverse transcriptase inhibitors fails to predict virologic response to combination therapy in children (PACTG 338). AIDS Research and Therapy 4: 2. en_US
dc.identifier.issn 1742-6405 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:7349730
dc.description.abstract Background: The association between baseline drug resistance mutations and subsequent increase in viral failure has not been established for HIV-infected children. We evaluated drug resistance mutations at 39 codon sites (21 protease inhibitor (PI) resistant codons and 18 nucleoside reverse transcriptase inhibitor (NRTI) resistant codons) for 92 clinically stable NRTI-experienced, PI-naive HIV-infected children 2 to 17 years of age who were initiating new therapy with ritonavir plus zidovudine (ZDV) and lamivudine or plus stavudine. The association between baseline drug resistance mutations and subsequent viral failure after 12 and 24 weeks of highly active antiretroviral therapy (HAART) was studied. Results: There were few primary PI associated mutations in this PI-naïve population, but 84% had NRTI mutations – codons 215 (66%), 41 (42%), 67 (37%), 210 (33%) and 70 (32%). None of the specific baseline drug resistance mutations were associated with a higher rate of virologic failure after 12 or 24 weeks of HAART. Median week 12 viral load decreased as the total number of NRTI mutations at baseline increased (P = 0.006). Specifically, a higher level of baseline ZDV resistance mutation was associated with a decrease in viral failure after 12 weeks on a ZDV-containing HAART regimen (P = 0.017). Conclusion: No increase was seen in the rate of viral failure after HAART associated with the presence of resistance mutations at baseline. This paradoxical result may be due to adherence, replicative capacity, or ZDV hypersusceptibility to the new regimen. en_US
dc.language.iso en_US en_US
dc.publisher BioMed Central en_US
dc.relation.isversionof doi://10.1186/1742-6405-4-2 en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1802955/pdf/ en_US
dash.license LAA
dc.title Baseline Resistance to Nucleoside Reverse Transcriptase Inhibitors Fails to Predict Virologic Response to Combination Therapy in Children (PACTG 338) en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal AIDS Research and Therapy en_US
dash.depositing.author McIntosh, Kenneth
dc.date.available 2012-01-09T01:09:20Z
dash.affiliation.other SPH^Immunology and Infectious Diseases en_US
dash.affiliation.other HMS^Pediatrics-Children's Hospital en_US

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