Prevalence of the HIV-1 protease mutation I47A in clinical practice and association with lopinavir resistance

AIDS. 2006 Apr 24;20(7):1071-4. doi: 10.1097/01.aids.0000222084.44411.cc.

Abstract

Mutation proI47A has recently been associated with lopinavir/ritonavir (LPV/r) resistance. Only four out of 1859 specimens (0.2%) sent for drug resistance testing (219 drug-naive and 1650 antiretroviral-experienced) showed I47A. All belonged to patients failing LPV/r. The prevalence among protease inhibitor-experienced patients was 0.6%. Phenotypic testing showed that proI47A caused high-level lopinavir resistance (> 100-fold) and cross-resistance to amprenavir, whereas it caused hypersusceptibility to saquinavir. ProI47A should thus be considered the primary lopinavir resistance mutation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carbamates / therapeutic use
  • Codon / genetics
  • Drug Resistance, Viral / genetics
  • Furans
  • Genotype
  • HIV Infections / drug therapy
  • HIV Infections / genetics*
  • HIV Protease Inhibitors / blood
  • HIV Protease Inhibitors / therapeutic use*
  • HIV-1 / drug effects
  • HIV-1 / genetics*
  • Humans
  • Indinavir / therapeutic use
  • Lopinavir
  • Mutation
  • Nelfinavir / therapeutic use
  • Phenotype
  • Pyrimidinones / blood
  • Pyrimidinones / therapeutic use*
  • Ritonavir / therapeutic use
  • Saquinavir / therapeutic use
  • Sulfonamides / therapeutic use

Substances

  • Carbamates
  • Codon
  • Furans
  • HIV Protease Inhibitors
  • Pyrimidinones
  • Sulfonamides
  • Lopinavir
  • amprenavir
  • Indinavir
  • Nelfinavir
  • Saquinavir
  • Ritonavir