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La transmisión de las variantes antirretrovirales del VIH-1 resistentes a los medicamentos
1Division of Infectious Diseases, Geneva University Hospital, Switzerland.
Lancet (London, England)
|September 4, 1999
Resumen
Las variantes de VIH-1 resistentes a los medicamentos se transmitieron a casi el 10% de las personas con infección primaria por VIH-1. Las pruebas de resistencia son cruciales para un tratamiento antirretroviral eficaz en pacientes recién infectados.
Área de la Ciencia:
- Virología Virología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Epidemiología molecular y epidemiología molecular.
Sus antecedentes:
- La resistencia a los medicamentos antirretrovirales es uno de los principales impulsores del fracaso del tratamiento del VIH-1.
- Comprender la transmisión de las variantes de VIH-1 resistentes a los medicamentos es fundamental para la salud pública.
Objetivo del estudio:
- Evaluar la prevalencia y las características de las variantes de VIH-1 resistentes a los medicamentos transmitidas durante la infección primaria.
Principales métodos:
- Secuenciación basada en la población de genes de transcriptasa inversa y proteasa del ARN viral plasmático.
- Pruebas de resistencia fenotípica para los inhibidores de la proteasa en individuos con múltiples mutaciones de resistencia.
Principales resultados:
- Se detectaron mutaciones de resistencia a la zidovudina en el 9% de los individuos.
- Las mutaciones de resistencia al inhibidor de la proteasa se encuentran en el 4% de los individuos, y algunos también tienen resistencia al inhibidor de la transcriptasa inversa.
- Un individuo albergaba el VIH-1 con 12 mutaciones que conferían resistencia a múltiples clases de fármacos.
Conclusiones:
- Las cepas de VIH-1 resistentes a los medicamentos se transmiten durante la infección primaria.
- Las pruebas de resistencia en individuos recientemente infectados son esenciales para guiar la selección óptima de la terapia antirretroviral.
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