Resistance to antiretroviral drugs in patients with primary HIV-1 infection

The widespread use of antiretroviral agents (ARVs) and the growing occurren ce of HIV strains resistant to these drugs have given rise to serious conce rns regarding the transmission of resistant viruses to newly infected perso ns. Plasma viral RNA from 80 individuals newly infected between 1997 and 19 99 was genotyped by automated sequencing to analyze the profile of viruses resistant to nucleoside and non-nucleoside reverse trarrscriptase inhibitor s (NRTIs and NNRTIs) and to protease inhibitors (PIs). The prevalence of mu tations that conferred primary resistance to PIs (L10I, D30Y, V82A, L90M) w as 15% of the cohort. RT genotypic variants, associated with high-level res istance to ARVs, were observed in 21% of individuals, including NRTI, NNRTI and multidrug (MDR) resistance in 6, 5, and 10% of cases, respectively. Th e phenotypic susceptibility of viral isolates to ARVs was also assayed and showed transmission of high-level resistance to ZDV, 3TC, and PIs in those individuals with MDR. The transmission of drug-resistant HIV genotypic vari ants is a serious problem that merits further attention by public health of ficials, virologists, and clinicians. (C) 2000 Elsevier Science B.V. and In ternational Society of Chemotherapy. All rights reserved.