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Pesquisa : G06.225.420 [Categoria DeCS]
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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


  5 / 107 LILACS  
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Id: biblio-888887
Autor: Ferreira, Ana Cristina G; Coelho, Lara E; Grinsztejn, Eduarda; Jesus, Carlos S de; Guimarães, Monick L; Veloso, Valdiléa G; Grinsztejn, Beatriz; Cardoso, Sandra W.
Título: Transmitted drug resistance in patients with acute/recent HIV infection in Brazil
Fonte: Braz. j. infect. dis;21(4):396-401, July-Aug. 2017. tab, graf.
Idioma: en.
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.
Descritores: Infecções por HIV/virologia
HIV-1/efeitos dos fármacos
HIV-1/genética
Inibidores da Protease de HIV/uso terapêutico
Fármacos Anti-HIV/uso terapêutico
Farmacorresistência Viral/genética
-Brasil
Infecções por HIV/genética
Infecções por HIV/tratamento farmacológico
Doença Aguda
Genótipo
Mutação
Limites: Humanos
Masculino
Feminino
Adulto
Responsável: BR1.1 - BIREME


  6 / 107 LILACS  
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Lunge, Vagner Ricardo
Simón, Daniel
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Id: biblio-974222
Autor: Paoli, Juliana de; Wortmann, André Castagna; Klein, Mirelli Gabardo; Pereira, Vagner Reinaldo Zingalli Bueno; Cirolini, Adriana Maria; Godoy, Bibiane Armiliato de; Fagundes, Nelson Jurandi Rosa; Wolf, Jonas Michel; Lunge, Vagner Ricardo; Simon, Daniel.
Título: HBV epidemiology and genetic diversity in an area of high prevalence of hepatitis B in southern Brazil
Fonte: Braz. j. infect. dis;22(4):294-304, July-Aug. 2018. tab, graf.
Idioma: en.
Projeto: CNPq.
Resumo: ABSTRACT Background Hepatitis B virus (HBV) infection is a major public health problem in Brazil. HBV endemicity is usually moderate to low according to geographic regions, and high prevalence of this virus has been reported in people of some specific Brazilian counties, including those with a strong influence of Italian colonization in southern Brazil. Analysis of HBV diversity and identification of the main risk factors to HBV infection are necessary to understand hepatitis B epidemiology in these high prevalence regions in southern Brazil. Objective To investigate epidemiological characteristics and HBV genotypes and subgenotypes circulating in a specific city with high HBV prevalence. Methods A cross-sectional study was performed with 102 HBV chronically infected individuals, recruited in reference outpatient clinics for viral hepatitis in a city of high HBV prevalence (Bento Gonçalves) in Rio Grande do Sul state, Brazil between July and December 2010. Socio-demographic, clinical and behavior-related variables were collected in a structured questionnaire. HBV serological markers (HBsAg, anti-HBc), viral load, genotypes/subgenotypes and drug resistance were evaluated and comparatively analyzed among all patients. Results The HBV infected subjects had a mean age of 44.9 (±12.2) years, with 86 patients (84.3%) reporting to have a family history of HBV infection, 51 (50.0%) to share personal objects, and were predominantly of Italian descendants (61; 64.9%). There was a predominance of genotype D (49/54; 90.7%), but genotype A was also detected (5/54; 9.3%). Subgenotypes D1 (1; 4.7%), D2 (3; 14.3%), and D3 (17; 81.0%) were identified. LAM-resistant mutation (rtM204I) and ADV-resistant mutations (rtA181V) were detected in only one patient each. Conclusions These results demonstrate a pivotal role of intrafamilial transmission for HBV spreading in this population. Furthermore, there is a high prevalence of HBV genotype D in this region.
Descritores: Vírus da Hepatite B/genética
Hepatite B Crônica/epidemiologia
Farmacorresistência Viral
-Antivirais/uso terapêutico
Brasil/epidemiologia
Vírus da Hepatite B/efeitos dos fármacos
Reação em Cadeia da Polimerase
Prevalência
Estudos Transversais
Fatores de Risco
Carga Viral
Hepatite B Crônica/virologia
Genótipo
Antígenos de Superfície da Hepatite B/sangue
Mutação
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Pessoa de Meia-Idade
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-984016
Autor: Zhang, Jingmin; Wang, Yafeng; Peng, Youmei; Qin, Chongzhen; Liu, Yixian; Li, Jingjing; Jiang, Jinhua; Zhou, Yubing; Chang, Junbiao; Wang, Qingduan.
Título: Novel fluoronucleoside analog NCC inhibits lamivudine-resistant hepatitis B virus in a hepatocyte model
Fonte: Braz. j. infect. dis;22(6):477-486, Nov.-Dec. 2018. tab, graf.
Idioma: en.
Projeto: This work was supported by grants from the Natural Science Foundation of China; . Young Innovation Foundation of The First Affiliated Hospital of Zhengzhou University of China.
Resumo: ABSTRACT Antiviral drug resistance is the most important factor contributing to treatment failure using nucleos(t)ide analogs such as lamivudine for chronic infection with hepatitis B virus (HBV). Development of a system supporting efficient replication of clinically resistant HBV strains is imperative, and new antiviral drugs are needed urgently to prevent selection of drug-resistant HBV mutants. A novel fluorinated cytidine analog, NCC (N-cyclopropyl-4′-azido-2′-deoxy-2′-fluoro-β-d-cytidine), was recently shown to strongly inhibit human HBV in vitro and in vivo. This study was designed to evaluate the antiviral activity of NCC against lamivudine-resistant HBV. We generated a stable cell line encoding the major pattern of lamivudine-resistant mutations rtL180M/M204V and designated it "HepG2.RL1". Immuno-transmission electron microscopic examination and enzyme-linked immunosorbent assay were used to detect secretion of HBV-specific particles and antigens. Quantification of extracellular DNA and intracellular DNA of HepG2.RL1 cells by quantitative real-time polymerase chain reaction revealed >625-fold and >5556-fold increases in the 50% inhibitory concentration of lamivudine, respectively, compared with that for the wild-type virus. The results showed that NCC inhibited DNA replication and HBeAg production in wild-type or lamivudine-resistant HBV in a dose-dependent manner. In conclusion, screening for antiviral compounds active against lamivudine-resistant HBV can be carried out with relative ease using hepG2.RL1 cells. NCC is a potential antiviral agent against wild-type HBV and clinical lamivudine-resistant HBV and deserves evaluation for the treatment of HBV infection.
Descritores: Antivirais/farmacologia
Replicação Viral/efeitos dos fármacos
Vírus da Hepatite B/efeitos dos fármacos
Lamivudina/farmacologia
Citidina/análogos & derivados
-DNA Viral/química
Testes de Sensibilidade Microbiana
Linhagem Celular
Vírus da Hepatite B/isolamento & purificação
Vírus da Hepatite B/fisiologia
Hepatócitos/virologia
Farmacorresistência Viral/efeitos dos fármacos
Mutação
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


  8 / 107 LILACS  
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Id: lil-741611
Autor: Souza, Thiago Moreno Lopes e; Fintelman-Rodrigues, Natalia; Resende, Paola Cristina; Mesquita, Milene; Gregianini, Tatiana Schaffer; Bozza, Fernando A; Pecego, Ana Carla; Fernandes, Sandra Bianchini; Cury, Ana Luisa Furtado; Riediger, Irina Nastassja; Siqueira, Marilda M.
Título: Oseltamivir-resistant influenza A(H1N1)pdm2009 strains found in Brazil are endowed with permissive mutations, which compensate the loss of fitness imposed by antiviral resistance
Fonte: Mem. Inst. Oswaldo Cruz;110(1):101-105, 03/02/2015. tab, graf.
Idioma: en.
Resumo: The 2009 pandemic influenza A virus outbreak led to the systematic use of the neuraminidase (NA) inhibitor oseltamivir (OST). Consequently, OST-resistant strains, carrying the mutation H275Y, emerged in the years after the pandemics, with a prevalence of 1-2%. Currently, OST-resistant strains have been found in community settings, in untreated individuals. To spread in community settings, H275Y mutants must contain additional mutations, collectively called permissive mutations. We display the permissive mutations in NA of OST-resistant A(H1N1)pdm09 virus found in Brazilian community settings. The NAs from 2013 are phylogenetically distinct from those of 2012, indicating a tendency of positive selection of NAs with better fitness. Some previously predicted permissive mutations, such as V241I and N369K, found in different countries, were also detected in Brazil. Importantly, the change D344N, also predicted to compensate loss of fitness imposed by H275Y mutation, was found in Brazil, but not in other countries in 2013. Our results reinforce the notion that OST-resistant A(H1N1)pdm09 strains with compensatory mutations may arise in an independent fashion, with samples being identified in different states of Brazil and in different countries. Systematic circulation of these viral strains may jeopardise the use of the first line of anti-influenza drugs in the future. (AU)
Descritores: Vírus da Influenza A
Farmacorresistência Viral
Oseltamivir/farmacologia
-Mutação/efeitos dos fármacos
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: BR1618.1 - CID - Centro de Informação e Documentação


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Id: biblio-1083389
Autor: Guimarães, Paula Morena de Souza.
Título: Avaliação do perfil de resistência aos antirretrovirais em crianças e adolescentes infectados pelo HIV-1 / Evaluation of antiretroviral resistance profile in HIV-1 infected children and adolescents.
Fonte: São Paulo; s.n; 2015. [115] p. tab, graf.
Idioma: pt.
Tese: Apresentada a São Paulo (Estado) Secretaria da Saúde. Coordenadoria de Controle de Doenças, Programa de Pós – Graduação em Ciências para obtenção do grau de Mestre.
Resumo: Crianças e adolescentes em uso de terapia antirretroviral de alta atividade(HAART) caracterizam um grupo especialmente vulnerável no contexto daepidemia pelo HIV-1...O presente estudo tem como objetivo avaliar os genes da protease e transcriptase reversa em crianças e adolescentes vivendo comHIV/aids. Foi realizada uma análise retrospectiva... Entre os pacientes expostos às três classes com mais de uma entrada (n=27), não houve aumento de mutação para essas classes em relação a genotipagemimediatamente anterior. A alta proporção de resistência aos IP em subtipos Fobservada nesse estudo sugere que o uso dos IP deve ser avaliado levandoem consideração o possível impacto na resposta terapêutica. Os dadosdesse estudo demonstram uma taxa intermediária de resistência transmitidae uma elevada proporção de casos com resistência entre os pacientes emfalha, embasa a noção de que esta população representa um segmento derisco para a evolução da doença.

Children and adolescents on highly active antiretroviral therapy (HAART)represents a vulnerable group in the context of the HIV-1 epidemic, due tobiological issues and different socio-behavioral aspects such as those relatedto adherence to HAART... A retrospective analysis was made, in samples collected from naïve patients and patients exposed to antiretrovirals(ART) with virological failure...Among patients exposed to the three ART classes with more than one genotyping test (n=27), mutations prevalence seemed to not increase when we compared with the previous genotyping test, however most of patients samples showed resistance to the main ART available for use. The high proportion of resistance to IP among subtype F suggests thatin these cases, the IP administration should be evaluated considering apossible impact on therapeutic response. Our results showed an intermediaterate of transmitted resistance e a high proportion of resistance amongpatients with virological failure, supporting the fact that this populationrepresents more risk to disease progression.
Descritores: HIV-1
Adolescente
Criança
Farmacorresistência Viral/genética
Mutação
Terapia Antirretroviral de Alta Atividade/tendências
Limites: Humanos
Criança
Adolescente
Responsável: BR91.2 - Centro de Documentação
BR91.2; W4, G963a


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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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