Third International Congress Drug Therapy in HIV Infection 3-7 November 1996 Glasgow, UK

INCREASING FREQUENCY OF ANTIVIRAL NAÏVE PATIENTS HARBORING 215-MUTANT HIV-1 VIRUS DURING 1989-1996

A. Rubio, M. Leal, JA. Pineda C. Rey, M. Olivera, A. Sanchez-Quijano, J. Macias, E. Lissen
Viral Hepatitis and AIDS group, Virgen del Rocio University Hospital, Avda. Manuel Siurot s/n, Seville, Spain.

Int Cong Drug Therapy HIV 1996 Nov 3-7;3:Abstract No. OP2.4
AIDS 1996, Vol. 10 (Suppl. 2);S11

Transmission of Zidovudine (ZDV) resistant virus is not unexpected, since massive treatment with the drug has been performed in the last years and this mutant strain has been reported to be capable to be transmitted. We tried to assess the frequency of appearance during the period 1989-1990 on naïve patients of a common and stable marker of ZDV resistance, the 215-mutation of the HIV virus pol gen. Other factors potentially involved in the appearance of this mutation (CD4+ cell counts, antigen p24, clinical state and transmission way of the virus) were also studied.

210 patients who enrolled our cohort from 1989 to 1996 were included at the point of starting the treatment, being evaluated their viral genotype by a selective PCR from peripheral blood mononuclear cells as previously described.

From 210 patients studied, 27 possessed the 215-mutant genotype (12.8 %). The frequency of primary mutations was progressive increasing during the years studied. From no cases with the mutant variant found in the first two years period (1989-90), we got during 1991-92 an 11% percentage with the mutant strain, 15% in the next two years (1993-94), reaching in 1995-96 a percentage of 42% (Pearson Chisquare, p < 0.01). However, mutant genotype emergence was also dependent of the immunological state of the patients being lower the CD4+ cell counts mean for individuals with mutant virus variants than for patients with the wild ones. After analyzing the data by a multivariant statistical model it was found that the immunodepression level of the patients was the only variable significantly associated to the emergence of the mutant variant (Logistic regression, p < 0.005).

In summary, we have found that since 1989 there is an augment of naïve patients harboring the 215-mutant virus in our cohort that seems to be dependent of their immunological state. Further experiments would be necessary analyzing clinical implications of these finding in order to improve the future management of new infected patients.

Presenting author: A. Rubio

1996-11-03
OP2.4

Originally published in AIDS Volume 10, Supplement 2 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701

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