Data/hora: 05/06/2024 17:15:05

Provedor de dados: | 55
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