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Journal of Clinical Microbiology, October 2002, p. 3865-3866, Vol. 40, No. 10
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.10.3865-3866.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Rate of Virological Treatment Failure and Frequencies of Drug Resistance Genotypes among Human Immunodeficiency Virus-Positive Subjects on Antiretroviral Therapy in Spain

Oscar Gallego,1 Lidia Ruíz,2 Alex Vallejo,3 Bonaventura Clotet,2 Manuel Leal,3 and Vincent Soriano1*

Service of Infectious Diseases, Hospital Carlos III, Instituto de Salud Carlos III, Madrid,1 Fundació IrsiCaixa, Barcelona,2 Hospital Virgen del Rocío, Seville, Spain3

Received 19 February 2002/ Returned for modification 17 June 2002/ Accepted 19 July 2002

The knowledge of which drug-resistant human immunodeficiency virus (HIV) genotypes are the most prevalent in a community may be helpful for designing the best salvage regimens. A total of 540 individuals on antiretroviral therapy attending 18 different outclinics in Spain were examined in a cross-sectional study conducted during June 2000. The overall rate of virologic failure (>50 HIV RNA copies/ml) was 54%. Among the subjects showing treatment failure, 79% harbored resistant HIV genotypes, 77% showed resistance to nucleoside analogues, 53% showed resistance to protease inhibitors, and 42% showed resistance to nonnucleoside reverse transcriptase inhibitors. Overall, 78.5% of individuals harbored HIV strains which showed resistance to two or more drug classes. Moreover, nucleotide substitutions causing broad cross-resistance among compounds within each drug family were quite common. These findings suggest that drug resistance mutations are very prevalent among subjects who have experienced several treatment failures. Therefore, facilitating the arrival of compounds belonging to new drug classes should be considered a priority.

* Corresponding author. Mailing address: Service of Infectious Diseases, Hospital Carlos III, Instituto de Salud Carlos III, Calle Nueva Zelanda 54, 4 B, Madrid 28035, Spain. Phone: 34 91 4532500. Fax: 34 91 7336614. E-mail: vsoriano{at}dragonet.es.

Journal of Clinical Microbiology, October 2002, p. 3865-3866, Vol. 40, No. 10
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.10.3865-3866.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.





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