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Antivir Ther ; 7(3): 151-7, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12487381

RESUMO

Genotype-based resistance assays are commonly used to aid treatment in HIV-infected individuals failing antiretroviral therapy. The relationship between genotype and antiretroviral therapy comes mostly from in vitro assays of the response to a single drugs although there is a need for a prediction of clinical response to combination therapy. We have compared three different methods of analysing genotype data as a predictor of clinical response in a small clinical cohort of highly antiretroviral-experienced individuals failing therapy. No method performed well beyond 8 weeks into a new therapeutic regimen. A model based on the number of 'primary' mutations was statistically significant, but a multiple regression model, which identified specific mutations explained threefold more variation in response. Optimal prediction in this dataset was given by a model obtained from a classification tree analysis, in which genotype at amino acid sites 135 and 202 were combined with amino acid site 184, which explained over 50% of the deviance in the data and had a classification success of 86%.


Assuntos
Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral , Infecções por HIV/virologia , HIV/efeitos dos fármacos , HIV/genética , Modelos Biológicos , Adulto , Sequência de Aminoácidos , Fármacos Anti-HIV/uso terapêutico , Feminino , Variação Genética , Genótipo , HIV/enzimologia , Infecções por HIV/tratamento farmacológico , Protease de HIV/química , Protease de HIV/genética , Transcriptase Reversa do HIV/química , Transcriptase Reversa do HIV/genética , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Filogenia , Estudos Retrospectivos
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