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首页> 外文期刊>JAIDS: Journal of acquired immune deficiency syndromes >Clinical and genotypic findings in HIV-infected patients with the K65R mutation failing first-line antiretroviral therapy in Nigeria.
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Clinical and genotypic findings in HIV-infected patients with the K65R mutation failing first-line antiretroviral therapy in Nigeria.

机译：在尼日利亚，HIV感染的K65R突变患者在一线抗逆转录病毒治疗失败后的临床和基因型检查结果。

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INTRODUCTION: The HIV-1 epidemic in African countries is largely due to non-B HIV-1 subtypes. Patterns and frequency of antiretroviral drug resistance mutations observed in these countries may differ from those in the developed world, where HIV-1 subtype B predominates. METHODS: HIV-1 subtype and drug resistance mutations were assayed among Nigerian patients with treatment failure on first-line therapy (plasma HIV RNA >1000 copies/mL). Sequence analysis of the reverse transcriptase and protease gene revealed drug resistance mutations and HIV-1 viral subtype. Specific patterns of mutations and clinical characteristics are described in patients with the K65R mutation. RESULTS: Since 2005, 338 patients were evaluated. The most prevalent subtypes were CRF02_AG [152 of 338 (44.9%)] and G [128 of 338 (37.9%)]. Three hundred seven of 338 (90.8%) patients had previously received stavudine and/or zidovudine + lamivudine + efavirenz or nevirapine; 41 of 338 (12.1%) had received tenofovir (TDF). The most common nucleoside reverse transcriptase inhibitor mutations observed were M184V (301, 89.1%) and K70R (91, 26.9%). The K65R mutation was present in 37 of 338 patients (10.9%). The Q151M (P < 0.05), K219R, and T69del (P < 0.01) mutations were more common in patients with K65R who had not received TDF. CONCLUSIONS: The K65R mutation is increasingly recognized and is a challenging finding among patients with non-B HIV subtypes, whether or not they have been exposed to TDF.
机译：简介：非洲国家的HIV-1流行很大程度上归因于非B HIV-1亚型。在这些国家中观察到的抗逆转录病毒药物耐药性突变的模式和频率可能不同于以HIV-1 B型亚型为主的发达国家。方法：在一线治疗（血浆HIV RNA> 1000拷贝/ mL）的治疗失败的尼日利亚患者中检测HIV-1亚型和耐药性突变。逆转录酶和蛋白酶基因的序列分析揭示了耐药性突变和HIV-1病毒亚型。患有K65R突变的患者描述了特定的突变模式和临床特征。结果：自2005年以来，已评估338例患者。最流行的亚型是CRF02_AG [338个中的152个（44.9％）]和G [338个中的128个（37.9％）]。 338名患者中的三百零七（90.8％）曾接受司他夫定和/或齐多夫定+拉米夫定+依非韦伦或奈韦拉平治疗; 338名患者中有41名（12.1％）已接受替诺福韦（TDF）。观察到的最常见的核苷逆转录酶抑制剂突变是M184V（301，89.1％）和K70R（91，26.9％）。 338名患者中的37名存在K65R突变（10.9％）。 Q151M（P <0.05），K219R和T69del（P <0.01）突变在未接受TDF的K65R患者中更为常见。结论：在非B HIV亚型患者中，无论是否接触过TDF，K65R突变都得到了越来越多的认可，这是一个具有挑战性的发现。

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