| Registro completo |
| Provedor de dados: |
BJID
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| País: |
Brazil
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| Título: |
Transmitted drug resistance in patients with acute/recent HIV infection in Brazil
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| 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.
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| Data: |
2017-08-01
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| Ano: |
2017
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| Palavras-chave: |
HIV
Infection
Transmission
Primary resistance
Antiretroviral therapy
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| 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.
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| Tipo: |
Info:eu-repo/semantics/article
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| Idioma: |
Inglês
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| Identificador: |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702017000400396
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| Editor: |
Brazilian Society of Infectious Diseases
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| Relação: |
10.1016/j.bjid.2017.03.013
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| Formato: |
text/html
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| Fonte: |
Brazilian Journal of Infectious Diseases v.21 n.4 2017
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| Direitos: |
info:eu-repo/semantics/openAccess
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