ABSTRACT
Se presentan las características epidemiológicas, clínicas, inmunológicas y la metodología de diagnóstico en una serie de 7 pacientes HIV positivos con polirradiculoimielitis por CMV, asistidos en un hospital de enfermedades infecciosas de referencia.
Subject(s)
Humans , Cytomegalovirus , AIDS Dementia Complex/diagnosis , Spinal Cord Diseases/diagnosis , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/epidemiologyABSTRACT
Here we present a survey including 52 drug-naive recently HIV-1-infected subjects from Buenos Aires City and province (79%) and 3 other regions in Argentina (21%). Recent infections were established from previous negative serology (32/52), indeterminate Western blot (12/52), or acute retroviral syndrome after high-risk HIV exposure (8/52) within 9 months before genotyping (median time, 4.2 months). Genotyping was performed from plasma by sequencing both protease and reverse transcriptase. Phylogenetic analysis combined with bootscanning resulted in 21 subtype B sequences and 31 B/F recombinants (RecBF). On protease, minor resistance-related mutations were found in both subtype B and RecBF with low frequencies. The substitution L89M, recently suggested as a resistance-related mutation in some subtype F viruses, was observed in 1 RecBF. On reverse transcriptase, major resistance-related mutations were found in 4 of 52 (7.7%) patients from different health centers: M41L (subtype B) and K103N+/-P225H (1 RecBF and 2 subtype B). The greater than 5% resistance threshold found indicates a need for sentinel resistance surveillances calling for an update in the current resistance testing guidelines in Argentina.
