Mutaciones de resistencia a los antirretrovirales en pacientes infectados por el VIH-1. Implicaciones clínicas y epidemiológicas
Author
Gallego Donoso, Oscar ManuelAdvisor
Soriano Vazquez, VicenteEntity
UAM. Departamento de Biología MolecularDate
2003-12-18Subjects
Sida-Virus-Tesis doctorales; Medicamentos contra el sida-Tesis doctorales; Sida-Tratamiento-Tesis doctorales; Biología y Biomedicina / BiologíaNote
Tesis Doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Ciencias Biológicas, Departamento de Biología Molecular, fecha de lectura 18-12-2003Abstract
The goal of antiretrovirai therapy is to suppress HIV replication as much and long as
possible. However, virologic failure with combination therapy occurs in a significant
propornon of patients. This fact has been amibuted to several factors, including low drug
potency, poor adherente to treatment, pharmawkinetic interactions, increases in CD4
lymphocytes providing more target cells for virus replication, and the selection of dmgresistant
variants.
Several prospective controlled stucfies have shown thai the presence of h g
resistance before starting a new dmg regimen is an independent predictor of treatment
virological response. Patients whose physicians have access to drug resistance data, respond
better to therapy than others whosephysicians do not have access to these assays.
In our study, genotypic testing has been shown to be clinically useful. The presence
of dmg resistance mutations in a wmpliant patient determine a change in treatment as soon as
the virological failure is confirmed. Our data favour scveial considerations. Treabnent
intensification (ritonavir-boosting) in .&ose patients without dmg resistance genotypes, or a
selective substitution of drug affected in hose with resistance might be justified. Surveillance
studies uf drug resistance mutatioas in a community in dnig naive and treatment-experienced
HIVinfected individuals may provide useful information for the design of preferred dmg
wmbinations. When the rate of resistance to one compound reaches a critica1 level, it rnight
be prudent m avoid its use.
Files in this item
Size
2.974Mb
Format
PDF
Description
"Texto de la Tesis Doctoral"
Google Scholar:Gallego Donoso, Oscar Manuel
This item appears in the following Collection(s)
Related items
Showing items related by title, author, creator and subject.
-
Implicación de la mutación K65R en la resistencia a tenofovir y otros fármacos antirretrovirales
Gutiérrez Montero, Carolina
2005