Emerging HIV-1 resistance to tipranavir and darunavir in patients with virological failure to first-generation protease inhibitors in Taiwan

• Published in: International journal of STD & AIDS 2011-11, Vol.22 (11), p.617-620
• Main Authors: Hsieh, S-M, Chang, S-Y, Hung, C-C, Sheng, W-H, Chen, M-Y, Chang, S-C
• Format: Article
• Language: English
• Subjects: Adult; AIDS/HIV; Anti-HIV Agents - administration & dosage; Anti-HIV Agents - pharmacology; Antiretroviral Therapy, Highly Active - methods; Biological and medical sciences; Darunavir; Drug Resistance, Viral; Epidemiology. Vaccinations; Female; General aspects; HIV Infections - drug therapy; HIV Infections - virology; HIV Protease - genetics; HIV Protease Inhibitors - administration & dosage; HIV Protease Inhibitors - pharmacology; HIV-1 - drug effects; HIV-1 - isolation & purification; Human immunodeficiency virus 1; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Mutation, Missense; Pyridines - administration & dosage; Pyridines - pharmacology; Pyrones - administration & dosage; Pyrones - pharmacology; Sulfonamides - administration & dosage; Sulfonamides - pharmacology; Taiwan; Treatment Failure; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0956-4624; 1758-1052
• DOI: 10.1258/ijsa.2009.009007

Summary Ritonavir-boosted tipranavir (TPV/r) and darunavir (DRV/r) have been approved in patients with virological resistance to multiple protease inhibitors (Pis). Whether the HIV-1 from these patients with virological failure to first-generation Pls remains susceptible to TPV/r or DRV/r is questionable. The susceptibilities of HIV-1 isolates to second-generation Pls in patients who experienced virological failure in three time periods were analysed: 9-2006 to 4-2007 (period 1), 5-2007 to 12-2007 (period 2) and 1-2008 to 8-2008 (period 3). A total of 53 subjects were enrolled, and 51 subject isolates (96.2%) were resistant to ≥1 Pls. The mutation scores for TPV and DRV, and the percentage of isolates with resistance to TPV or DRV, increased significantly from period 1 to period 3. Our data revealed a significant increase in the levels of genotypic resistance to TPV and DRV over the past two years in patients with virological failure to first-generation Pls.