Data/hora: 04/06/2024 02:49:20

Provedor de dados: 	Brazilian Journal of Infectious Diseases	
País: 	Brazil	
Título: 	Transmitted drug resistance in patients with acute/recent HIV infection in Brazil	
Autores: 	Ferreira,Ana Cristina G.; Coelho,Lara E.; Grinsztejn,Eduarda; Jesus,Carlos S. de; Guimarães,Monick L.; Veloso,Valdiléa G.; Grinsztejn,Beatriz; Cardoso,Sandra W.	
Data: 	2017-08-01	
Ano: 	2017	
Palavras-chave: 	HIV; Infection; Transmission; Primary resistance; Antiretroviral therapy.	
Resumo: 	Abstract  Introduction: The widespread use of antiretroviral therapy increased the transmission of antiretroviral resistant HIV strains. Antiretroviral therapy initiation during acute/recent HIV infection limits HIV reservoirs and improves immune response in HIV infected individuals. Transmitted drug resistance may jeopardize the early goals of early antiretroviral treatment among acute/recent HIV infected patients.  Methods: Patients with acute/recent HIV infection who underwent resistance test before antiretroviral treatment initiation were included in this analysis. HIV-1 sequences were obtained using an in house protease/reverse transcriptase genotyping assay. Transmitted drug resistance was identified according to the Stanford HIV Database for Transmitted Drug Resistance Mutations, based on WHO 2009 surveillance list, and HIV-1 subtyping according to Rega HIV-1 subtyping tool. Comparison between patients with and without transmitted drug resistance was made using Kruskal-Wallis and Chi-square tests.  Results: Forty-three patients were included, 13 with acute HIV infection and 30 with recent HIV infection. The overall transmitted drug resistance prevalence was 16.3% (95% confidence interval [CI]: 8.1-30.0%). The highest prevalence of resistance (11.6%, 95% CI: 8.1-24.5) was against non-nucleoside reverse transcriptase inhibitors, and K103N was the most frequently identified mutation.  Conclusions: The high prevalence of nonnucleoside reverse transcriptase inhibitors resistance indicates that efavirenz-based regimen without prior resistance testing is not ideal for acutely/recently HIV-infected individuals in our setting. In this context, the recent proposal of including integrase inhibitors as a first line regimen in Brazil could be an advantage for the treatment of newly HIV infected individuals. However, it also poses a new challenge, since integrase resistance test is not routinely performed for antiretroviral naive individuals. Further studies on transmitted drug resistance among acutely/recently HIV-infected are needed to inform the predictors of transmitted resistance and the antiretroviral therapy outcomes among these population.	
Tipo: 	Info:eu-repo/semantics/article	
Idioma: 	Inglês	
Identificador: 	http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702017000400396	
Editor: 	Brazilian Society of Infectious Diseases	
Relação: 	10.1016/j.bjid.2017.03.013	
Formato: 	text/html	
Fonte: 	Brazilian Journal of Infectious Diseases  v.21 n.4 2017	
Fonte: 	info:eu-repo/semantics/openAccess