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
Mem. Inst. Oswaldo Cruz
;
103(2): 143-149, Mar. 2008. tab
Artículo
en Inglés
| LILACS
| ID: lil-480637
ABSTRACT
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 percent) had intermediate-level resistance to RT inhibitors. Among 38 patients on therapy as of sampling, 28 (73.7 percent) had plasma viral load (PVL) below detection limit (26 of whom without evidence of resistance mutations) and 11 (28.9 percent) 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 percent) 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.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Infecciones por VIH
/
VIH-1
/
Fármacos Anti-VIH
/
Farmacorresistencia Viral
/
Mutación
Tipo de estudio:
Estudio observacional
/
Estudio de prevalencia
/
Factores de riesgo
Límite:
Adulto
/
Niño
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
Mem. Inst. Oswaldo Cruz
Asunto de la revista:
Medicina Tropical
/
Parasitología
Año:
2008
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Fiocruz/BR
Similares
MEDLINE
...
LILACS
LIS