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
Article
Dans Anglais
| 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.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Infections à VIH
/
VIH-1 (Virus de l'Immunodéficience Humaine de type 1)
/
Agents antiVIH
/
Résistance virale aux médicaments
/
Mutation
Type d'étude:
Étude observationnelle
/
Étude de prévalence
/
Facteurs de risque
Limites du sujet:
Adulte
/
Enfant
/
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Mem. Inst. Oswaldo Cruz
Thème du journal:
Médecine tropicale
/
Parasitologie
Année:
2008
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Fiocruz/BR
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