RESUMO
SETTINGS: In Tunisia, therapeutic failure profile is detected in 42.22% of treated patients. These patients are still confronted to ethical and socioeconomic problems but also to therapeutic and technical ones. Indeed, the limited number of available antiretroviral (ARV) molecules and the unavailability of resistance genotypic test in routine use is the reason why the same therapeutic combination of ARV molecules is maintained after therapeutic failure in some cases. OBJECTIVE AND METHOD: The authors studied the evolution, on two consecutive samples, of resistance mutations in patients with prolonged exposure to the same therapeutic combination after therapeutic failure and the resulting effect on management of these patients. RESULTS: We found a greater number of patients presenting with mutant viral stains after a prolonged exposure to the same ARV molecules. Results also showed that the detected mutation frequency increased and even more on the second sample, compared to the first one. Thus, the early diagnostic of resistance mutations using genotypic resistance test would be of great interest by allowing the physician to take necessary measures to reduce resistance rate and find an optimal treatment for the patient. CONCLUSION: The introduction of new ARV molecules in our country was also an important step by improving the therapeutic management of HIV infected patients.
