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 | 2021-03-11T15:34:16Z | |
Available date | 2021-03-11T15:34:16Z | |
Document date | 2017 | |
Citation | FERREIRA, Ana Cristina G. et al. Prevalence of primary resistance among acutely/recently HIV infected patients in Rio de Janeiro, Brazil. The Brazilian Journal of Infectious Diseases, v. 21, n. 4, p. 1-6, 2017 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/46339 | |
Language | eng | pt_BR |
Publisher | Elsevier | pt_BR |
Rights | restricted access | pt_BR |
Subject in Portuguese | HIV | pt_BR |
Subject in Portuguese | Infection | pt_BR |
Subject in Portuguese | Transmission | pt_BR |
Subject in Portuguese | Primary resistance | pt_BR |
Subject in Portuguese | Antiretroviral therapy | pt_BR |
Title | Prevalence of primary resistance among acutely/recently HIV infected patients in Rio de Janeiro, Brazil | pt_BR |
Type | Preprint | pt_BR |
Abstract | Introduction: The widespread use of antiretroviral therapy (ART) increased the transmission
of antiretroviral resistant HIV strains. ART initiation during acute/recent HIV infection limits
HIV reservoirs and improves immune response in HIV infected individuals. Transmitted
drug resistance (TDR) may jeopardize the early goals of early ART among acute/recent HIV
infected patients.
Methods: Patients with acute/recent HIV infection who underwent resistance test before ART
initiation were included in this analysis. HIV-1 sequences were obtained using an in house
protease/reverse transcriptase genotyping assay. TDR 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 TDR 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 TDR 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 nonnucleoside reverse transcriptase inhibitors (NNRTI), and K103N was the most frequently
identified mutation.
Conclusions: The high prevalence of NNRTI 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 ART 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 ART naive individuals. Further studies on
TDR among acutely/recently HIV-infected are needed to inform on predictors of TDR and
ART outcomes among these population. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. 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. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |