Adolescents recently infected with HIV-1 have high rates of primary drug resistance, according to a report in the December 1st issue of The Journal of Infectious Diseases.

Other studies have shown an increased prevalence of primary HIV-1 genotypic resistance, the authors explain, but these studies have been conducted predominantly with middle-aged white men.

Dr. Rolando M. Viani from University of California, San Diego School of Medicine, and colleagues investigated the prevalence of primary genotypic and phenotypic HIV-1 drug resistance patterns among 55 recently infected youth ranging in age from 12-to-24 years old.

Ten patients (18%) had major mutations conferring drug resistance, the authors report, including eight (15%) with nonnucleoside reverse-transcriptase inhibitor (NNRTI) mutations, two (4%) with nucleoside reverse-transcriptase inhibitor (NRTI) mutations, and two (4%) with protease inhibitor (PI) mutations.

Twelve patients (22%) showed evidence of phenotypic drug resistance, the results indicate, distributed similarly among the antiretroviral drug classes.

“The rates of NNRTI-resistant HIV-1 that we report in these recently infected adolescents and young adults are among the highest ever reported in the United States, and the overall rates of drug resistance are concerning,” the researchers write.

“The high prevalence of NNRTI genotypic and phenotypic drug resistance in recently infected youth places them at risk of poor response to future NNRTI-based regimens,” the investigators explain. “These observations support the current guidelines for resistance testing in adults and adolescents recently infected with HIV-1 before initiating antiretroviral therapy.”

J Infect Dis 2006;194:1505-1509.



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