Multiple Resistance and Unusual Mutations from HIV-1 Infecting Peruvian Patients with Highly Active Antiretroviral Therapy
We have analyzed the molecular resistance profile of HIV infecting Peruvian individuals during the first three years that genotyping test was implemented free of charge. According our results, from 297 patients 80% of them were resistant to one or more antiretroviral (ART). M184V was the most frequent resistant mutation (30% for children and 26% for adults). Resistant profile revealed that children showed more resistance to 3TC / FTC (78%), while in adults it was EFV / NVP (50%). Pan-sensitive patients showed similar virological and immunological failure as those of resistant patients. We have also identified six patients showing Pan-resistance, including a 7-year-old subject. Additional sequence analysis revealed two cases of hypermutation with multiple stop codons. Finally, we found twenty-four resistant patients who were genotyped two or more times, however only fifteen (63%) of them were changed to other treatment schedule. As a consequence of this, only five patients (21%) experienced a decrease in their VL. We showed that HIV resistance profile in Peru is complex and follows different molecular evolution depending of age group. Moreover, recent resistant mutations emergency requires a re-planning of therapy strategies that help to diminish the resistance in Peruvian population.