Drug‐resistance mutations in antiretroviral‐naïve patients with established HIV‐1 infection in Mexico

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Abstract
Objectives: To describe the prevalence of baseline drug‐resistance mutations, resistance to antiretroviral drugs, and the subsequent virological response to therapy in treatment‐naïve patients from Mexico with established HIV‐1 infection.Methods: Resistance testing was performed on plasma samples from antiretroviral‐naïve patients. Data on mutations associated with antiretroviral drug resistance were obtained using Stanford software (http://hivdb.stanford.edu).Results: Ninety‐six treatment‐naïve individuals were enrolled in the study during 2002–2003. Of these, 83 patients (86%) had at least one resistance mutation and 15 (16%) had drug resistance. At baseline, the mean plasma viral load was 299 834 HIV‐1 RNA copies/mL, and at follow‐up it was 37 620 copies/mL (P<0.0001). Primary mutations in the reverse transcriptase region were observed in 15% of patients. For nucleoside inhibitors, mutations T215Y/C and F77L (3%) and D67N/S, T69N and M184V (2%), were detected. For nonnucleoside inhibitors, mutations K103N/R (6%), Y181C (3%) and G190A (2%) were detected. Overall, 6% of patients showed resistance to delavirdine and nevirapine, 4% to efavirenz, and 2% to lamivudine and nelfinavir. Twelve patients showed no response to treatment and three of these patients had antiretroviral drug resistance.Conclusions: The prevalence of baseline drug‐resistance mutations found in this study was similar to that found in previous reports for newly HIV‐infected individuals, although access to and management of antiretrovirals in Mexico are different.