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Among 128 patients routinely receiving highly active antiretroviral therapy in an HIV/AIDS outpatient clinic in Cameroon, 16.4% had drug resistance after a median of 10 months. Of these, 12.5% had resistance to nucleoside reverse transcriptase inhibitors (NRTIs), 10.2% to non-NRTIs, and 2.3% to protease inhibitors. [ABSTRACT FROM AUTHOR]

Genotypic drug resistance interpretation algorithms have been developed on patients infected with HIV-1 subtype B to interpret complex patterns of mutations. As non-B strains are characterised by the natural presence of several resistance-related mutations, we examined to what extent this might result in interalgorithm discordances in naive and treated patients. We compared the prediction by three algorithms (ANRS, Stanford and Rega) of drug susceptibilities to diverse HIV-1 strains from 272 naive and 156 treated patients. In naive patients, higher levels of interalgorithm discordance were observed for predictions of protease inhibitor (0.60–39%) than for predictions of reverse transcriptase inhibitor susceptibility (0–4%). The main reason for discordant protease inhibitor interpretation was the presence of resistance mutations that were natural protease polymorphisms. In contrast, in the treated patients, more interalgorithm discordances were observed for predictions of reverse transcriptase inhibitor (5–48%) than protease inhibitor susceptibilities (10–31%). Discordances were related to disagreement between the intermediate and susceptible scores, the intermediate and resistant scores and the interpretations of complex mutation patterns, related to cross-resistance and antagonistic interactions. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the resistance-mutation patterns in the reverse transcriptase and protease genes of HIV-1-infected persons with failure of highly active antiretroviral therapy. Methodology of the study; Results and discussion.

Assesses the long-term survival, immunologic and virologic effectiveness adherence, and drug resistance in HIV-infected patients receiving highly active antiretroviral therapy in Africa. Percentage of patients with undetectable viral load; Benefits of antiretroviral therapy; Rate of emergence of resistant strains among antiretroviral-naive patients.