Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2013 Sep;123(9):3704-5.
doi: 10.1172/JCI71784. Epub 2013 Aug 27.

Lack of protease inhibitor resistance following treatment failure--too good to be true?

John A Bartlett  1
Affiliations
Comment

Lack of protease inhibitor resistance following treatment failure--too good to be true?

John A Bartlett. J Clin Invest. 2013 Sep.

Abstract

A 29-year-old man with recently diagnosed HIV infection and a CD4 cell count of 225/mm³ began treatment with atazanavir (300 mg), ritonavir (100 mg), emtricitabine (200 mg), and tenofovir (300 mg) daily. For 18 months, he was treatment adherent and his plasma HIV RNA level was below the limit of detection. He then began a relationship with a new partner, who introduced him to methamphetamines. His medication adherence became erratic, and he missed appointments in clinic. Eventually. he was hospitalized for rehabilitation, and he resumed taking his medications on schedule. Following his discharge, he was found to have a plasma HIV RNA level of 11,400 copies/ml. Genotypic resistance testing revealed only an M184V mutation associated with emtricitabine resistance. A decision regarding his next treatment regimen needs to be made.

PubMed Disclaimer

Comment on

References

    1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in the treatment of HIV-1-infected adults and adolescents. Department of Health and Human Services Web site. http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf . Accessed June 27, 2013.
    1. Kempf D, et al. Incidence of resistance in a double-blind study comparing lopinavir/ritonavir plus stavudine and lamivudine to nelfinavir plus stavudine and lamivudine. J Inf Dis. 2004;189(1):51–60. doi: 10.1086/380509. - DOI - PubMed
    1. Eron J, et al. The KLEAN study of fosamprenavir-ritonavir versus lopinavir-ritonavir, each in combination with abacavir-lamivudine, for initial treatment of HIV infection over 48 weeks: a randomized non-inferiority trial. Lancet. 2006;368(9534):476–482. doi: 10.1016/S0140-6736(06)69155-1. - DOI - PubMed
    1. Riddler S, et al. Class-sparing regimens for initial treatment of HIV-1 infection. N Engl J Med. 2008;358(20):2095–2106. doi: 10.1056/NEJMoa074609. - DOI - PMC - PubMed
    1. Daar E, et al. Atazanavir plus ritonavir or efavirenz as part of a 3-drug regimen for initial treatment of HIV-1. Ann Intern Med. 2011;154(7):445–456. doi: 10.7326/0003-4819-154-7-201104050-00316. - DOI - PMC - PubMed

Publication types