Author | Ferreira, Ana Cristina G. | |
Author | Coelho, Lara E. | |
Author | Grinsztejn, Eduarda | |
Author | Jesus, Carlos S. de | |
Author | Guimarães, Monick L. | |
Author | Veloso, Valdiléa G. | |
Author | Grinsztejn, Beatriz | |
Author | Cardoso, Sandra W. | |
Access date | 2017-11-30T10:13:35Z | |
Available date | 2017-11-30T10:13:35Z | |
Document date | 2017 | |
Citation | FERREIRA, Ana Cristina G. et al. Transmitted drug resistance in patients with acute/recent HIV infection in Brazil. The Brazilian Journal of Infectious Diseases, v. 21, n. 4, p. 396-401, 2017. | pt_BR |
ISSN | 1413-8670 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/23456 | |
Language | eng | pt_BR |
Publisher | Elsevier | pt_BR |
Rights | open access | |
Subject in Portuguese | HIV | pt_BR |
Subject in Portuguese | Infecção | pt_BR |
Subject in Portuguese | Transmissão | pt_BR |
Subject in Portuguese | Terapia Antiretrovirais | pt_BR |
Subject in Portuguese | Resistência primária | pt_BR |
Title | Transmitted drug resistance in patients with acute/recent HIV infection in Brazil | pt_BR |
Type | Article | |
DOI | 10.1016/j.bjid.2017.03.013 | |
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. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ. Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ. Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ. Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ. Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ. Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ. Brasil. | pt_BR |
Subject | HIV | pt_BR |
Subject | Infection | pt_BR |
Subject | Transmission | pt_BR |
Subject | Primary resistance | pt_BR |
Subject | Antiretroviral therapy | pt_BR |
e-ISSN | 1678-4391 | |