[Prevalence of primary resistance mutations in patients with newly diagnosed HIV infection in the province of Málaga (Spain)]. / Prevalencia de mutaciones de resistencia primaria en los nuevos diagnósticos de infección por el VIH en la provincia de Málaga.

INTRODUCTION: The reported prevalence of primary resistance mutations differs between studies. An analysis was performed to determine the prevalence of primary resistance mutations and HIV subtypes in our area. METHODS: Prospective study performed in all patients diagnosed with HIV in the year 2005 in the province of Malaga (Spain). Plasma samples from these patients were tested for genotypic resistance (TruGene HIV-1 genotyping kit; Bayer Healthcare Diagnostics) and HIV subtype. RESULTS: A total of 172 cases were diagnosed, 6 of them recent seroconvertors. Genotype resistance testing disclosed resistance mutations in 7.8% (95% CI 3.5-12.0%) of 153 patients in which it was performed (6 to NNRTIs, 4 to NRTIs, and 3 to PIs). HIV subtype was B in 81.8% of patients, and non-B in 18.1% (51.8% of them of sub-Saharan origin, in whom the prevalence of this subtype was 73.6%). Among European patients, only those from Spain presented the non-B subtype (prevalence 7.4%). The only factor related with the presence of resistance mutations was seroconversion (OR 9.2; 95% CI 1.3-61.9; P < .02). CONCLUSIONS: There was a considerable prevalence of primary resistance mutations in patients with newly diagnosed HIV infection in Malaga province, with seroconversion being the only related factor. The high prevalence of the non-B HIV subtype in the Spanish population is noteworthy. Genotype resistance testing is recommendable in all newly diagnosed HIV patients in our area.

Prevalencia de mutaciones de resistencia primaria en los nuevos diagnósticos de infección por el VIH en la provincia de Málaga / Prevalence of primary resistance mutations in patients with newly diagnosed HIV infection in the province of Málaga (Spain)

Introducción. La prevalencia de mutaciones primarias de resistencia varía según los estudios. Analizamos dicha prevalencia, así como los subtipos del virus de la inmunodeficiencia humana (VIH) en nuestra área. Métodos. Estudio prospectivo en el que se realiza un test genotípico (Trugene HIV-1 genotyping kit; Bayer Healthcare Diagnostics) de resistencias e identificación del subtipo de VIH a todos los pacientes diagnosticados de infección por VIH en la provincia de Málaga durante el año 2005. Resultados. Se diagnosticaron 172 casos, 6 de ellos seroconversores recientes. Presentaron mutaciones de resistencia el 7,8% (intervalo de confianza [IC] del 95%: 3,5; 12,0%) de los 153 pacientes en los que se pudo tener un test genotípico (6 a los inhibidores de la transcriptasa inversa no análogos de los nucleósidos [ITINAN], 4 a los inhibidores de la transcriptasa inversa análogos de los nucleósidos [ITIAN], y 3 a los inhibidores de la proteasa [IP]). El 81,8% de los pacientes tenían subtipo B del VIH y el 18,1% no B (51,8% de ellos eran subsaharianos en los que la prevalencia de este subtipo fue del 73,6%). Entre los pacientes europeos sólo los españoles presentaron subtipo no B (prevalencia del 7,7%). El único factor que se asoció con mutaciones de resistencia fue la seroconversión (odds ratio [OR]: 9,2; IC 95%: 1,3-61,9; p < 0,02). Conclusiones. La prevalencia de mutaciones de resistencia en pacientes con nuevo diagnóstico de infección por el VIH en la provincia de Málaga no es despreciable, y la seroconversión es el único factor que se asoció a su presencia. Destaca la alta prevalencia de VIH subtipo no B en la población española. Con estos datos se debe recomendar la realización de tests genotípicos de resistencia en todos los nuevos diagnósticos de nuestra área (AU)

Introduction. The reported prevalence of primary resistance mutations differs between studies. An analysis was performed to determine the prevalence of primary resistance mutations and HIV subtypes in our area. Methods. Prospective study performed in all patients diagnosed with HIV in the year 2005 in the province of Malaga (Spain). Plasma samples from these patients were tested for genotypic resistance (TruGene HIV-1 genotyping kit; Bayer Healthcare Diagnostics) and HIV subtype. Results. A total of 172 cases were diagnosed, 6 of them recent seroconvertors. Genotype resistance testing disclosed resistance mutations in 7.8% (95% CI 3.5-12.0%) of 153 patients in which it was performed (6 to NNRTIs, 4 to NRTIs, and 3 to PIs). HIV subtype was B in 81.8% of patients, and non-B in 18.1% (51.8% of them of sub-Saharan origin, in whom the prevalence of this subtype was 73.6%). Among European patients, only those from Spain presented the non-B subtype (prevalence 7.4%). The only factor related with the presence of resistance mutations was seroconversion (OR 9.2; 95% CI 1.3-61.9; P < .02). Conclusions. There was a considerable prevalence of primary resistance mutations in patients with newly diagnosed HIV infection in Malaga province, with seroconversion being the only related factor. The high prevalence of the non-B HIV subtype in the Spanish population is noteworthy. Genotype resistance testing is recommendable in all newly diagnosed HIV patients in our area (AU)