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Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors
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Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors

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Multi-drug resistant HIV-1 reverse transcriptase genotype in children treated with dual nucleoside reverse

Chulapan Engchanil1, Pope Kosalaraksa, Viraphong Lulitanond

  • 1Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. cengchanil@yahoo.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|November 30, 2006
PubMed

Insights

Prolonged dual antiretroviral therapy in children can lead to multi-drug resistant HIV mutants. Genotyping identified high rates of nucleoside analog mutations, aiding in future treatment decisions for pediatric HIV.

Area of Science:

  • Pediatric infectious diseases
  • Virology
  • Antiretroviral therapy

Background:

  • Prolonged dual antiretroviral therapy (ART) is associated with the emergence of multi-drug resistant human immunodeficiency virus (HIV) mutants.
  • Understanding resistance patterns in pediatric populations is crucial for effective HIV management.

Purpose of the Study:

  • To determine the prevalence and specific resistance patterns of HIV in children receiving dual nucleoside reverse transcriptase inhibitor (NRTI) therapy.
  • To assess the clinical utility of genotypic testing in guiding subsequent treatment regimens.

Main Methods:

  • Retrospective review of medical records for HIV-infected children treated with dual NRTIs at Srinagarind Hospital, Thailand.
  • HIV genotyping of stored plasma samples to detect specific mutations conferring antiretroviral resistance.

Main Results:

  • Sixty percent of 57 children on dual NRTI therapy for a median of 22 months exhibited three or more nucleoside analog mutations (NAMs).
  • These NAMs conferred multi-dideoxynucleoside resistance, particularly in children receiving zidovudine and didanosine.
  • Genotypic testing revealed significant resistance profiles in this pediatric cohort.

Conclusions:

  • Dual NRTI therapy for extended periods in children leads to a high prevalence of NAMs.
  • Genotypic resistance testing is a valuable tool for optimizing second-line antiretroviral regimens in pediatric HIV patients.
Abstract

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