Prevalence of HIV type 1 drug resistance mutations in treatment-naïve and experienced patients from resource-limited settings with universal access to antiretroviral therapy: a survey in two small Brazilian cities
Título del documento: Prevalence of HIV type 1 drug resistance mutations in treatment-naïve and experienced patients from resource-limited settings with universal access to antiretroviral therapy: a survey in two small Brazilian cities
Revue: Memorias do Instituto Oswaldo Cruz
Base de datos: PERIÓDICA
Número de sistema: 000334617
ISSN: 0074-0276
Autores: 1
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1
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Instituciones: 1Fundacao Instituto Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro. Brasil
Año:
Periodo: Mar
Volumen: 103
Número: 2
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Descriptivo
Resumen en inglés Concerns have been raised that universal availability of antiretroviral agents in resource-limited settings might lead to the emergence and spread of resistant strains. We present the largest survey on human immunodeficiency virus type 1 (HIV-1) resistance among treatment-naïve and experienced patients followed in small, relatively underprivileged cities in Brazil with universal availability to standard of care antiretroviral combinations. Samples were collected between 2004 and 2006 from 95 patients followed in the cities of Saquarema and Santo Antonio de Pádua, state of Rio de Janeiro. A proviral fragment encompassing protease and reverse transcriptase (RT) regions was generated and drug susceptibility level was inferred. Among 50 strains from drug-naïve subjects, one (2%) had intermediate-level resistance to RT inhibitors. Among 38 patients on therapy as of sampling, 28 (73.7%) had plasma viral load (PVL) below detection limit (26 of whom without evidence of resistance mutations) and 11 (28.9%) harbored strains with reduced susceptibility. Only two strains harbored both protease and RT inhibitor mutations. Among seven patients who were off-treatment as of sampling, two (28.5%) harbored strains with reduced susceptibility to RT inhibitors. The relatively high frequency of undetectable PVL among patients on treatment and the overall low prevalence of resistance-associated mutations are reassuring. Continued surveillance, however, is necessary
Disciplinas: Medicina
Palabras clave: Farmacología,
Salud pública,
Inmunología,
Virus,
VIH-1,
Mutaciones,
Resistencia a fármacos,
Epidemiología,
Terapia antirretroviral,
Brasil
Keyword: Medicine,
Pharmacology,
Public health,
Immunology,
Virus,
HIV-1,
Mutations,
Drug resistance,
Epidemiology,
Antiretroviral therapy,
Brazil
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