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pubmed-article:20562063pubmed:abstractTextThe success of first-line antiretroviral therapy can be challenged by the acquisition of primary drug resistance. Here we report a case where baseline genotypic resistance testing detected resistance conferring nucleoside/nucleotide reverse transcriptase inhibitor (NRTI)-associated mutations, but no primary mutations for protease inhibitor (PI). Subsequent PI-based HAART with boosted saquinavir led to virological treatment success with persistently undetectable viral load. After treatment simplification from saquinavir to an atazanavir based PI-therapy and no change in backbone therapy rapid virological breakthrough occurred. Retrospective analysis displayed preexisting gag cleavage site mutations which may have reduced the genetic barrier in a clinical relevant manner in combination with the already existing NRTI resistance mutations. Alternatively, this effect could be explained with a different antiviral potency for the respective PIs used.lld:pubmed
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pubmed-article:20562063pubmed:articleTitleTransmission of human immunodeficiency virus I drug resistance - a case report. What are the clinical implications?lld:pubmed
pubmed-article:20562063pubmed:affiliationDepartment of General Internal Medicine, University of Bonn, Sigmund-Freud Strasse 25, 53105 Bonn, Germany. evrim.anadol@ukb.uni-bonn.delld:pubmed
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