Genotypic drug resistance and cause of death in HIV-infected persons who died in 1999

Citation
Nk. Beinker et al., Genotypic drug resistance and cause of death in HIV-infected persons who died in 1999, J ACQ IMM D, 28(3), 2001, pp. 250-253
Citations number
8
Categorie Soggetti
Clinical Immunolgy & Infectious Disease",Immunology
Journal title
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
ISSN journal
15254135 → ACNP
Volume
28
Issue
3
Year of publication
2001
Pages
250 - 253
Database
ISI
SICI code
1525-4135(20011101)28:3<250:GDRACO>2.0.ZU;2-M
Abstract
We analyzed the relationship between viral drug resistance and causes of de ath in 29 HIV-1-infected patients who had been followed in an HIV-outpatien t clinic and died in 1999. Six patients (21%) died with plasma HIV-RNA leve ls < 1000 copies/ml. Seven (24%) died with wild-type (WT) virus in plasma, 6 (21%) had reverse transcriptase (RT) mutations only, 10 (34%) had multidr ug-resistant (MDR) virus. The causes of death were not differently distribu ted among these groups, however, 8 of 16 patients (50%) with resistant viru ses died of end-organ failure versus 2 of 7 patients (29%) with WT virus. S eventeen of 32 patients (53%) were thought by their physicians to be noncom pliant with prescribed therapy, Major resistance mutations to antiretrovira l drugs were present in viruses from at least 55% of our HIV-1-infected pat ients who died in 1999. Nonetheless, deaths also occurred among patients wi th well-controlled HIV infection and among patients with WT virus in plasma . Infections related to incomplete immune restoration, inability to maintai n suppressive antiretroviral drug levels, and end-organ failures all contri bute to mortalities in the era of highly active antiretroviral therapy.