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Id: biblio-1021437
Autor: Guimarães, Paula Morena de Souza; Ferreira, João Leandro de Paula; Coelho, Luana Portes Ozório; Cavalcanti, Jaqueline de Souza.
Título: Transmitted drug resistance among recently diagnosed adults and children in São Paulo, Brazil
Fonte: AIDS Res Hum Retroviruses;31(12), 2015.
Idioma: en.
Resumo: Transmitted drug resistance mutations (TDRM) have been a constant threat to treatment efficacy. We evaluated TDRM in plasma RNA of 217 antiretroviral therapy-naive patients from sites in the São Paulo metropolitan area, collected from 2012 to 2014. The partial HIV-1 polymerase region was sequenced using Big Dye terminators at an ABI 3130 Genetic Analyzer. TDRM was defined according to the Stanford database calibrated population resistance (CPR v.6.0), but other drug resistance mutations (DRM) considered at the IAS list (IAS, 2014) and at the Stanford HIV Database Genotyping Resistance Interpretation (GRI-HIVdb) were also described. Out of 78% (170/217) of patients with information on the time of diagnosis, most (83%, 141/170) had been recently diagnosed, with the first positive HIV serology at a median of 58 days (IQR 18-184). Subtype B predominated (70%), followed by subtype F (10%), BF (7.5%), C (7.5%), and BC (5%). TDRMs were observed in 9.2% (20/217, CI 95% 5.9% to 13.6%), mostly (5.2%) to nonnucleoside reverse transcriptase inhibitor (NNRTI) antiretroviral class. Among children and adolescents, only a single patient showed TDRMs. Additional non-CPR mutations were observed: 11.5% (25/217) according to IAS or 4.6% (10/217) according to GRI-HIVdb. Overall, 23.5% (51/217) of the cases had one or more DRM identified. TDRM prevalence differed significantly among some sites. These trends deserve continuous and systematic surveillance, especially with the new policies of treatment as prevention being implemented in the country.
Descritores: Brasil
Humanos
Resistência a Medicamentos
Infecções por HIV
Criança
Pré-Escolar
Adolescente
HIV
Transmissão de Doença Infecciosa
Adulto
Produtos do Gene pol do Vírus da Imunodeficiência Humana
Genótipo
Responsável: BR91.2 - Centro de Documentação



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