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M9651044.TXT
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1996-03-30
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Document 1044
DOCN M9651044
TI Genotypic and phenotypic characterization of HIV-1 isolated from
patients receiving (--)-2',3'-dideoxy-3'-thiacytidine.
DT 9505
AU Kavlick MF; Shirasaka T; Kojima E; Pluda JM; Hui F Jr; Yarchoan R;
Mitsuya H; Experimental Retrovirology Section, National Cancer
Institute,; Bethesda, MD 20892, USA.
SO Antiviral Res. 1995 Oct;28(2):133-46. Unique Identifier : AIDSLINE
MED/96126406
AB We attempted to determine whether HIV-1 developed resistance to
(--)-2',3'-dideoxy-3'-thiacytidine ((--)-3TC or 3TC, lamivudine) in
patients with advanced human immunodeficiency virus type 1 (HIV-1)
infection during therapy with 3TC. Genotypic analysis of HIV-1 strains
isolated from 6 patients receiving 3TC revealed that as early as 2
months of therapy, HIV-1 developed a Met to Val amino acid substitution
at codon 184 (Met184-->Val) in the reverse transcriptase-coding region
of the pol gene. A detailed study of a series of HIV-1 strains isolated
from a patient demonstrated that Met at codon 184 was first substituted
with Ile by 2 weeks of 3TC therapy, followed by the substitution with
Val by 8 weeks. All HIV-1 strains with the Met184-->Val substitution
were profoundly less susceptible to 3TC (1800- to 5500-fold decreased
sensitivity) as compared to pretherapy virus strains. These strains were
also moderately less sensitive to 2',3'-dideoxycytidine (4.5- to
9-fold), but more sensitive to 3'-azido-2',3'-dideoxythymidine (2- to
14-fold). A decrease in viremia levels and an increase in CD4 counts
were observed early in therapy; however, these changes were only
transient. Our data suggest that reversal of such beneficial changes is
associated with the Met184-->Val substitution of the pol gene of HIV-1.
The data also suggest that 3TC, as a single agent, may induce virologic
and immunologic improvement in patients with advanced HIV-1 infection,
but only transiently.
DE Adult Antiviral Agents/*PHARMACOLOGY CD4 Lymphocyte Count/DRUG EFFECTS
Drug Resistance, Microbial Genotype Human HIV Core Protein p24/BLOOD
HIV Infections/*DRUG THERAPY HIV-1/CLASSIFICATION/*DRUG
EFFECTS/GENETICS/ISOLATION & PURIF Leukocytes, Mononuclear/VIROLOGY
Male Middle Age Phenotype Reverse Transcriptase
Inhibitors/*PHARMACOLOGY Zalcitabine/*ANALOGS &
DERIVATIVES/PHARMACOLOGY Zidovudine/PHARMACOLOGY CLINICAL TRIAL
CLINICAL TRIAL, PHASE I CLINICAL TRIAL, PHASE II JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).