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Id: biblio-834305
Autor: Samayoa, Blanca; Moller, Anneliese; Medina, Narda; Arathoon, Eduardo; Lau-Bonilla, Dalia; Moller, Anneliese.
Título: Evaluación de resistencia genotípica del VIH-1 en pacientes con fallo virológico de Guatemala / Evaluation of genotypic resistance of HIV-1 in patients with virologic failure Guatemala
Fonte: Cienc. tecnol. salud;1(1):5-12, jul.-dic. 2014. ilus, graf.
Idioma: es.
Resumo: La resistencia a la terapia antirretroviral (TARV) es un factor determinante para el fallo virológico en pacientes con VIH. El objetivo de este estudio fue identificar los patrones genotípicos de resistencia en pacientes con fallo virológico. Fueron incluidos pacientes de las diferentes unidades de atención integral de VIH en Guatemala, de quienes se sospechaba resistencia y que necesitaban cambios en la TARV por fallo virológico, se requirió haber evaluado la adherencia y una carga viral ≥1,000 copias/ml. La información clínica y demográfica fue recolectada a través de la forma de solicitud. El análisis de resistencia se realizó a través de la metodología TRUGENE® HIV-1. La muestra se restringió a 25 pacientes por motivos de accesibilidad. El 68% de las muestras analizadas presentaron resistencia; por familia de ARV la resistencia fue de 88.2% para ITINN, 70.5% para ITIAN y 17.6% para IP. Se identificaron 79 mutaciones entre el grupo de estudio, el 46.8% de fueron asociadas a ITINN, 76.6% a ITIAN y 26.6% a IP. Para ITIAN las mutaciones más frecuentes fueron la M184V 43%, M184I 14% y K219E 10%; el 23.8% fueron mutaciones TAMs. Para ITINN fueron la V179D 16%, K103N 14%, G190A 14% y Y181C 14%. Para los IP la mutación más frecuente fue la M36I con 29%. La resistencia identificada en este grupo, fue menor a lo reportado en otros países latinoamericanos; sin embargo es similar a lo reportado por OMS en países con bajo o medio ingreso económico.

ARV drug resistance is one of the leading causes of virologic failure among HIV patients on HAART. Theobjective of this study was to determine genotypic resistance profiles among HIV patients on virologic failure. Patients from one HIV clinic in Guatemala on whom ARV drug resistance was suspected and needed a change in their ARV regimen due to virologic failure were included. In order to perform the genotype, the patient had to demonstrate good adherence to therapy and a confirmed viral load ≥1,000 copies/ml. Demographics andclinical data were collected through the resistance-testing questionnaire. The TRUGENE® HIV-1 methodology was used for resistance analysis. The patient sample was restricted to 25 patients due to accessibility, 68% presented resistance to at least one ARV drug. By ARV class, 88.2% presented resistance to NNRTIs, 70.5% to NRTIs and 17.6% to IPs. We found 79 mutations among the samples analyzed. Of the mutations found, 46.8% were associated with NNRTI resistance, 76.6% to NRTI resistance and the remainder 26.6% to PI resistance. The most frequent NRTI associated mutations were M184V 43%, M184I 14% and K219E 10%; 23.8% were TAM. The NNRTI associated mutations were V179D 16%, K103N 14%, G190A 14% and Y181C 14%. For the PI the most frequent mutation was M36I with 29%. The resistance found in this study was lower to that reported in other Latin American studies, however, it is similar to what is reported by WHO in low and middle income countries.
Descritores: HIV-1
Farmacorresistência Viral
-Antirretrovirais/imunologia
Mutação
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Estudo Comparativo
Responsável: GT49.1


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Texto completo SciELO Brasil
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Id: biblio-897064
Autor: Silva, Dorotéa de Fátima Lobato da; Cardoso, Jedson Ferreira; Silva, Sandro Patroca da; Arruda, Leda Mani França; Medeiros, Renato Lopes Fernandes de; Moraes, Marluce Matos; Sousa, Rita Catarina Medeiros.
Título: HCMV UL97 phosphotransferase gene mutations may be associated with antiviral resistance in immunocompromised patients in Belém, PA, Northern Brazil
Fonte: Rev. Soc. Bras. Med. Trop;51(2):141-145, Mar.-Apr. 2018. tab, graf.
Idioma: en.
Resumo: Abstract INTRODUCTION: Human cytomegalovirus is one of the causes of opportunist infections in immunocompromised patients, and is triggered by factors such as state of viral latency, weakened immune responses, and development of antiviral resistance to ganciclovir, the only drug offered by the public health system in Brazil to treat the infection. The goal of this study was to identify mutations that may be associated with antiviral resistance in immunocompromised patients. METHODS: Molecular analysis was performed in 82 blood samples and subjected to genomic DNA extraction by a silica-based method. Three sequences of the HCMV UL97 gene, which encodes a phosphotransferase protein required for activation of ganciclovir, were amplified by polymerase chain reaction. Pyrosequencing methods were applied to one external 2096-bp segment DNA and two internal sequences between nucleotides 1087 to 1828 to detect mutations in this gene. RESULTS: Approximately 10% of sequences contained mutations between nucleotides 377 and 594, in conserved regions of the UL97 gene, leading to amino acid changes. Eleven coding mutations were identified, including changes leading to amino acid substitutions, E596K and S604F, which were observed in 100% of samples and are described for the first time in Brazil. In addition, one mutation (A594V) that is associated with ganciclovir resistance was detected in a kidney transplant patient. CONCLUSIONS: Further studies to detect mutations associated with HCMV resistance to antiviral drugs are required to demonstrate the need to increase the variety and availability of drugs used to treat viral infections in the public health care system in Brazil.
Descritores: Antivirais/uso terapêutico
Fosfotransferases/genética
Hospedeiro Imunocomprometido
Infecções por Citomegalovirus/tratamento farmacológico
Citomegalovirus/enzimologia
Farmacorresistência Viral/genética
Mutação/genética
-Antivirais/farmacologia
Estudos de Casos e Controles
Reação em Cadeia da Polimerase
Estudos Transversais
Citomegalovirus/efeitos dos fármacos
Citomegalovirus/genética
Farmacorresistência Viral/efeitos dos fármacos
Genótipo
Limites: Humanos
Tipo de Publ: Estudo Observacional
Responsável: BR1.1 - BIREME


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Id: biblio-1052891
Autor: Benso, José; Ciapponi, Agustín.
Título: Uso de anillo vaginal con dapivirina para prevención de infección por HIV en mujeres / Use of a vaginal ring containing dapivirine for HIV prevention in women
Fonte: Evid. actual. práct. ambul;22(4):e001067, 2019.
Idioma: es.
Descritores: Pirimidinas/administração & dosagem
Infecções por HIV/prevenção & controle
HIV-1
Inibidores da Transcriptase Reversa/administração & dosagem
-Pirimidinas/efeitos adversos
Vagina
Infecções por HIV/epidemiologia
Método Duplo-Cego
Estudos Multicêntricos como Assunto
Fatores Etários
Cooperação do Paciente
Ensaios Clínicos Fase III como Assunto
Inibidores da Transcriptase Reversa/efeitos adversos
África Austral/epidemiologia
Farmacorresistência Viral
Ensaios Clínicos Controlados não Aleatórios como Assunto
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Pessoa de Meia-Idade
Adulto Jovem
Tipo de Publ: Comentário
Responsável: AR2.1 - Biblioteca Central


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Texto completo SciELO Chile
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Id: biblio-978065
Autor: González, Virginia; Gutiérrez, Stella.
Título: Prevalencia de resistencia a los anti-retrovirales en niños y adolescentes uruguayos infectados con el virus de la inmunodeficiencia humana en el Centro de Referencia VIH-SIDA. Centro Hospitalario Pereira Rossell. Montevideo-Uruguay / Prevalence of antiretroviral resistance in Uruguayan children and adolescents infected with the human immunodeficiency virus in the Reference Center HIV-AIDS. Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
Fonte: Rev. chil. infectol;35(5):509-517, 2018. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: A nivel mundial, la tasa global de resistencia primaria y secundaria a los anti-retrovirales (ARV) es de 15 y 40%, respectivamente. Se desconoce su prevalencia en Uruguay. Objetivo: Conocer la prevalencia de resistencia a los ARV en niños y adolescentes uruguayos bajo 15 años de edad infectados con VIH que se controlan en el Centro Hospitalario Pereira Rossell entre 2008 y 2016. Objetivos específicos: Cuantificar mutaciones de resistencia primarias y secundarias e identificar variables asociadas a resistencias; describir si el resultado del test de resistencia contribuyó a lograr una carga viral (CV) indetectable. Metodología: Descriptivo observacional, seguimiento longitudinal. Se incluyeron menores de 15 años con test de resistencia entre 1 de enero de 2008 y 15 de diciembre de 2016. Variables maternas y del niño. Resultados: Se incluyeron 56 niños. Tenían test de resistencia previo al inicio TARV 36 niños (64%) y por fallo terapéutico 20 (36%). La resistencia total fue 28,6% (16 niños): cuatro (11,1%) con mutaciones primarias y 12 (60%) secundarias. El test modificó el plan ARV en 15 (26,7%) de los 56 niños. El cambio logró CV indetectable a los seis meses en ocho casos. El cambio de TARV no se asoció con sida o muerte. Discusión: Los estudios de prevalencia son útiles para la toma de decisiones sobre la selección inicial de ARV. La prevalencia de mutaciones primarias fue similar a la publicada, mientras que la secundaria fue mayor.

Background: Primary and secondary antiretroviral (ARV) resistance rates of 15 and 40% respectively have been reported in worldwide. Its prevalence in Uruguay is unknown. Aim: To know the prevalence of ARV resistance in Uruguayan children under 15 years old infected with HIV that are controlled in the Centro Hospitalario Pereira Rossell between 2008 and 2016. Specific objectives: Quantify primary and secondary mutations, to identify variables associated with resistance; to describe if the result of the resistance test contributed to achieve undetectable viral load (VL). Methodos: Observational descriptive, longitudinal follow-up. Only children under 15 years with resistance test done between January first 2008 and December 31th 2016 were included in the study. Maternal and child variables. Results: Fifty six children were included. 36 children (64%) had resistance tests prior to the initiation of ART and the other 20 children (36%) due to therapeutic failure. Total resistance: 28.6% (16 children); 4 (11.1%) children with primary mutations and 12 (60%) secondary mutations. The test result changed the ARV plan in 15 (26.7%) of the 56 children. The change achieved undetectable CV in 8 children at month 6. The ART change was not associated with AIDS or death. Discussion: Prevalence studies are useful in making decisions about initial ARV treatment. The prevalence of primary mutations was similar to that published, while secondary prevalence was higher.
Descritores: Infecções por HIV/tratamento farmacológico
Infecções por HIV/virologia
Fármacos Anti-HIV/uso terapêutico
Farmacorresistência Viral/genética
Mutação/genética
-Uruguai
Prevalência
Estudos Longitudinais
Farmacorresistência Viral/efeitos dos fármacos
Limites: Humanos
Masculino
Feminino
Lactente
Pré-Escolar
Criança
Adolescente
Tipo de Publ: Estudo Observacional
Responsável: CL1.1 - Biblioteca Central


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Texto completo SciELO Brasil
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Id: lil-736371
Autor: Santos, Katia Corrêa de Oliveira; Silva, Daniela Bernardes Borges da; Benega, Margarete Aparecida; Paulino, Renato de Sousa; E Silva Jr, Elian Reis; Pereira, Dejanira dos Santos; Mussi, Aparecida Duarte Hg; Silva, Valéria Cristina da; V. Gubareva, Larissa; Paiva, Terezinha Maria de.
Título: Influenza virus surveillance by the Instituto Adolfo Lutz, influenza season 2014: antiviral resistance
Fonte: Rev. Inst. Med. Trop. Säo Paulo;57(1):92-92, Jan-Feb/2015.
Idioma: en.
Descritores: Vírus da Influenza A Subtipo H1N1/efeitos dos fármacos
/efeitos dos fármacos
INFLUENZA A VIRUS, HABATTOIRSNTEMEFOS SUBTYPE/efeitos dos fármacos
Vírus da Influenza B/efeitos dos fármacos
Influenza Humana/virologia
Vigilância da População
-Antivirais/uso terapêutico
Brasil
Farmacorresistência Viral
Influenza Humana/tratamento farmacológico
Estações do Ano
Limites: Humanos
Tipo de Publ: Carta
Responsável: BR1.1 - BIREME


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Id: biblio-887247
Autor: Oyagüez, Itziar; Buti, Maria; Brosa, Max; Rueda, Magdalena; Casado, Miguel A.
Título: Cost-Effectiveness and Clinical Impact of Antiviral Strategies of HBeAG-Positive and Negative Chronic Hepatitis B
Fonte: Ann. hepatol;16(3):358-365, May.-Jun. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Introduction. Chronic hepatitis B (CHB) is associated with high burden and healthcare costs. Virologic response achieved with antivirals is associated with progression avoidance. This study aimed to estimate the efficiency and clinical impact of antiviral strategies in CHB patients. Material and methods. A Markov model estimated lifetime complications and direct costs in both, HBeAg-positive and HBeAg-negative cohorts. Strategy 1 (71% of treated population) and strategy 2 (100%), both based on pegylated interferon (peg-IFN) followed by oral tenofovir or entecavir, were compared to no treatment. Progression was based on HBV-DNA levels. Rescue therapy with oral antivirals was applied for peg-IFN failure. Disease costs (€, 2014) and utilities were obtained from literature. Results. Compared to natural history, strategy 1 increased QALY (3.98 in HBeAg-positive, 2.16 in -negative cohort). With strategy 2, survival was up to 5.60 (HBeAg-positive) and 3.05 QALY (in HBeAg-negative). The model predicted avoidance of 128 and 86 carcinomas in HBeAg-positive and -negative patients with strategy 1, and up to 181 and 121 in HBeAg-positive and -negative for strategy 2. Total cost increased up to €102,841 (strategy 1) and €105,408 (strategy 2) in HBeAg-positive, and €85,858 and €93,754 in HBeAg-negative. A€1,581/QALY gained ratio was estimated versus the natural history for both strategies. In conclusion, increasing antiviral coverage would be efficient, reducing complications.
Descritores: Vírus da Hepatite B/efeitos dos fármacos
Custos de Medicamentos
Hepatite B Crônica/economia
Hepatite B Crônica/tratamento farmacológico
Antígenos E da Hepatite B/sangue
-Simulação por Computador
DNA Viral/sangue
Biomarcadores/sangue
Análise Custo-Benefício
Modelos Econômicos
Progressão da Doença
Carga Viral
Farmacorresistência Viral
Quimioterapia Combinada
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: lil-780800
Autor: Bottecchia, Marcelle; Barcaiu, Halime Silva; Lewis-Ximenez, Lia Laura; da Silva e Mouta Junior, Sergio; de Moraes, Marcia Terezinha Baroni.
Título: Monitoring the emergence of HBV resistance mutations by HBV-RNA pyrosequencing
Fonte: Braz. j. infect. dis;20(2):216-217, Mar.-Apr. 2016. tab.
Idioma: en.
Descritores: RNA Viral/genética
Vírus da Hepatite B/genética
Técnicas de Diagnóstico Molecular/métodos
Farmacorresistência Viral/genética
Mutação/genética
-Antivirais/farmacologia
Vírus da Hepatite B/efeitos dos fármacos
DNA Polimerase Dirigida por RNA/genética
Lamivudina/farmacologia
Limites: Humanos
Tipo de Publ: Research Support, Non-U.S. Gov't
Carta
Responsável: BR1.1 - BIREME


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Id: lil-780801
Autor: Zhao, Youyun; Wu, Jianhua; Sun, Lijun; Liu, Guangzhong; Li, Bo; Zheng, Yi; Li, Xiaodong; Tao, Junxiu.
Título: Prevalence of mutations in HBV DNA polymerase gene associated with nucleos(t)ide resistance in treatment-naive patients with Chronic Hepatitis B in Central China
Fonte: Braz. j. infect. dis;20(2):173-178, Mar.-Apr. 2016. tab.
Idioma: en.
Resumo: Abstract Objective There are a lot of disagreements in the studies on hepatitis B virus (HBV) DNA polymerase mutation rate associated with nucleos(t)ide analogues (NAs) in treatment-naive chronic hepatitis B (CHB) patients. This is the first study aimed to investigate the prevalence of spontaneous HBV resistance mutations in Central China. Methods This study included treatment-naive patients with CHB from June 2012 to May 2015 receiving care at the Institute of Liver Disease in Central China. All patients completed a questionnaire covering different aspects, such as family medical history, course of liver disease, medication history, alcohol use, among others. Mutations in HBV DNA polymerase associated with NAs resistance were detected using INNO-LiPA assay. Results 269 patients were infected with HBV genotype B (81.4%), C (17.9%), and both B and C (0.7%). Mutations in HBV DNA polymerase were detected in 24 patients (8.9%) including rtM204I/V (n = 6), rtN236T (n = 5), rtM250V (n = 2), rtL180M (n = 2), rtT184G (n = 1), rtM207I (n = 1), rtS202I (n = 1), rtM204V/I & rtL180M (n = 5), and rtM204I & rtM250V (n = 1). Conclusion Spontaneous HBV resistance mutations in HBV DNA polymerase were found in treatment-naive patients with CHB in Central China. These findings suggest that we should analyze HBV DNA polymerase resistance mutation associated with NAs before giving antiviral therapy such as lamivudine (LAM), adefovir (ADV), and telbivudine (LdT).
Descritores: DNA Viral/genética
Vírus da Hepatite B/genética
Hepatite B Crônica/virologia
Farmacorresistência Viral/genética
DNA Polimerase Dirigida por DNA/genética
Mutação/genética
-Antivirais/uso terapêutico
China
Vírus da Hepatite B/efeitos dos fármacos
Prevalência
Estudos Prospectivos
Hepatite B Crônica/tratamento farmacológico
Genótipo
Limites: Humanos
Masculino
Feminino
Gravidez
Adulto
Pessoa de Meia-Idade
Idoso
Adulto Jovem
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME


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Id: biblio-828125
Autor: Brites, Carlos; Pinto-Neto, Lauro; Medeiros, Melissa; Nunes, Estevão; Sprinz, Eduardo; Carvalho, Mariana.
Título: Extensive variation in drug-resistance mutational profile of Brazilian patients failing antiretroviral therapy in five large Brazilian cities
Fonte: Braz. j. infect. dis;20(4):323-329, July-Aug. 2016. tab, graf.
Idioma: en.
Resumo: Abstract Background Development of drug-resistance mutations is the main cause of failure in antiretroviral therapy. In Brazil, there is scarce information on resistance pattern for patients failing antiretroviral therapy. Objectives To define the HIV mutational profile associated with drug resistance in Brazilian patients from 5 large cities, after first, second or further failures to antiretroviral therapy. Methods We reviewed genotyping results of 1520 patients failing therapy in five Brazilian cities. Frequency of mutations, mean number of active drugs, viral susceptibility to each antiretrovirals drug, and regional differences were assessed. Results Mean time of antiretrovirals use was 22.7 ± 41.1 months. Mean pre-genotyping viral load was 4.2 ± 0.8 log (2.1 ± 2.0 after switching antiretrovirals). Mean number of remaining active drugs was 9.4, 9.0, and 7.9 after 1st, 2nd, and 3rd failure, respectively. We detected regional variations in drug susceptibility: while BA and RS showed the highest (∼40%) resistance level to ATV/r, FPV/r and LPV/r, in the remaining cities it was around half of this rate. We detected 90% efavirenz/nevirapine resistance in SP, only 45% in RS, and levels between 25% and 30% in the other cities. Regarding NRTI, we found a similar pattern, with RJ presenting the highest, and CE the lowest susceptibility rates for all NRTI. Zidovudine resistance was detected in only 3% of patients in RJ, against 45–65% in the other cities. RJ and RS showed 3% resistance to tenofovir, while in CE it reached 55%. DRV/r (89–97%) and etravirine (61–85%) were the most active drugs, but again, with a wide variation across cities. Conclusions The resistance mutational profile of Brazilian patients failing antiretroviral therapy is quite variable, depending on the city where patients were tested. This variation likely reflects distinctive choice of antiretrovirals drugs to initiate therapy, adherence to specific drugs, or circulating HIV-1 strains. Overall, etravirine and DRV/r remain as the most active drugs.
Descritores: Infecções por HIV/virologia
HIV-1/efeitos dos fármacos
HIV-1/genética
Fármacos Anti-HIV/farmacologia
Farmacorresistência Viral/genética
Mutação/genética
-Inibidores da Transcriptase Reversa/farmacologia
Carga Viral
Terapia Antirretroviral de Alta Atividade
Genótipo
Limites: Humanos
Adulto
Responsável: BR1.1 - BIREME


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Id: biblio-839208
Autor: Abreu, Juliana Costa de; Vaz, Sara Nunes; Martins Netto, Eduardo; Brites, Carlos.
Título: Virological suppression in children and adolescents is not influenced by genotyping, but depends on optimal adherence to antiretroviral therapy
Fonte: Braz. j. infect. dis;21(3):219-225, May-June 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective: To evaluate the virological outcomes in children and adolescents infected with HIV-1 in Salvador, Bahia according to genotyping results. Methods: We retrospectively evaluated the rates of virological suppression of children and adolescents submitted to HIV-1 genotyping test from January/2008 to December/2012. The participants were followed in the two referral centers for pediatric AIDS care, in Salvador, Brazil. Resistance mutations, drug sensitivity profiles, and viral subtypes were analyzed using the Stanford HIV-1 Drug Resistance Database. Adherence was estimated by drugs withdrawal at pharmacies of the two sites. Results: 101 subjects were included: 35 (34.6%) were drug-naïve, and the remaining 66 were failing ART. In drug-naïve group, 3 (8.6%), presented with NNRTIs resistance mutations, along with polymorphic mutations to PIs in most (82.8%) of them. Among the failing therapy group, we detected a high frequency (89.4%) of resistance mutations to PIs, NRTI (84.8%), and NNRTI (59.1%). Virological suppression after introduction/modification of genotyping-guided ART was achieved only for patients (53.1%) with drug withdrawal over 95%. Main detected HIV-1 subtypes were B (67.3%), F (7.9), C (1.9%), and recombinant forms (22.9%). Conclusions: Despite the use of genotyping tests in guidance of a more effective antiretroviral regimen, poor adherence to ART seems to be the main determinant of low virological suppression rate for children and adolescents, in Salvador, Brazil.
Descritores: Infecções por HIV/tratamento farmacológico
HIV-1/genética
Fármacos Anti-HIV/uso terapêutico
Farmacorresistência Viral/genética
Adesão à Medicação
Mutação
-Infecções por HIV/virologia
Estudos Transversais
Estudos Retrospectivos
Carga Viral/efeitos dos fármacos
Genótipo
Limites: Humanos
Masculino
Feminino
Lactente
Pré-Escolar
Criança
Adolescente
Responsável: BR1.1 - BIREME



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