%0 Journal Article
%A Fernández-Caballero, Jose Ángel
%A Chueca, Natalia
%A Álvarez, Marta
%A Mérida, María Dolores
%A López, Josefa
%A Sánchez, José Antonio
%A Vinuesa, David
%A Martínez, María Ángeles
%A Hernández, José
%A García, Federico
%T Usefulness of Integrase resistance testing in proviral HIV-1 DNA in patients with Raltegravir prior failure.
%D 2016
%U http://hdl.handle.net/10668/2382
%X BACKGROUNDIn our study, we have hypothesized that proviral DNA may show the history of mutations that emerged at previous failures to a Raltegravir containing regimen, in patients who are currently undetectable and candidates to simplification to a Dolutegravir containing regimen, in order to decide on once a day or twice a day dosing.METHODSWe have performed a pilot, observational, retrospective, non interventional study, including 7 patients infected by HIV-1, all with a history of previous failure to a RAL containing regimen, that were successfully salvaged and had reached viral suppression. A genotypic viral Integrase region study was available for each patient at the moment of RAL failure. After an average (IQR) time of 48 months (29-53) Integrase resistance mutations in proviral DNA were studied.RESULTSAll the patients were infected by HIV-1 B subtypes, with a mean age of 55 (range 43 to 56), originating from Spain, and 4 were women. Median viral load (log) and CD4 count at the moment of the study on proviral DNA was of 1.3 log cp/ml (range 0-1.47) and 765.5 cells/μL (range; 436.75-1023.75). The median time (IQR) between previous failure to RAL and the study on proviral DNA was 48 (29-53) months. At Raltegravir failure, N155H was detected in four patients, and other secondary mutations were detected in five patients (71.4 %). In proviral DNA, N155H was detected by population sequencing in three patients (42.8 %), and UDS demonstrated a 9.77 % relative abundance of N155H in the remaining patient. Sanger sequencing correctly identified all the secondary mutations.CONCLUSIONThis is a pilot study that demonstrates the possibility of properly identifying N155H and some secondary mutations 29-53 months after failure.
%K HIV
%K Integrase
%K Proviral DNA
%K Raltegravir
%K Dolutegravir
%K Recuento de linfocito CD4
%K ADN
%K Femenino
%K Infecciones por VIH
%K VIH-1
%K Compuestos heterocíclicos con 3 anillos
%K Humanos
%K Integrasas
%K Mutación
%K Proyectos piloto
%K Provirus
%K Raltegravir potásico
%K Estudios retrospectivos
%K España
%K Carga viral
%~