Artículos de revistas
Brazilian network for HIV Drug Resistance Surveillance (HIV-BresNet): a survey of treatment-naive individuals
Fecha
2018-03-01Registro en:
Journal Of The International Aids Society. Chichester: John Wiley & Sons Ltd, v. 21, n. 3, 8 p., 2018.
1758-2652
10.1002/jia2.25032
WOS:000429006000001
WOS000429006000001.pdf
Autor
Universidade Federal do Rio de Janeiro (UFRJ)
Fdn Med Trop Amazonas
LAPI Univ Fed Bahia
Lab Cent Saude Publ Ceara Lacen CE
Lab Cent Saude Publ Dist Fed
Universidade Federal de Minas Gerais (UFMG)
Lab Cent Saude Publ Mato Grosso Sul
Lab Cent Saude Publ Pernambuco
Lab Municipal Curitiba
Fiocruz MS
Inst Biol Exercito
Lab Cent Saude Publ Rio Grande Sul
Lab Hosp Nossa Senhora Conceicao
Lab Cent Saude Publ Santa Catarina
Universidade Estadual Paulista (Unesp)
Universidade Estadual de Campinas (UNICAMP)
Inst Adolfo Lutz Sao Jose do Rio Preto
Universidade Federal de São Paulo (UNIFESP)
Inst Adolfo Lutz Cent
Minist Saude
Universidade de Brasília (UnB)
Universidade de São Paulo (USP)
Institución
Resumen
Introduction: In Brazil, more than 487,450 individuals are currently undergoing antiretroviral treatment. In order to monitor the transmission of drug-resistant strains and HIV subtype distribution in the country, this work aimed to estimate its prevalence and to characterize the nationwide pretreatment drug resistance in individuals recently diagnosed with HIV between 2013 and 2015. Methods: The HIV threshold survey methodology (HIV-THS, WHO) targeting antiretroviral-naive individuals with recent HIV diagnosis was utilized, and subjects were selected from 51 highly populated cities in all five Brazilian macroregions. The HIV pol genotypic test was performed by genomic sequencing. Results: We analysed samples from 1568 antiretroviral-naive individuals recently diagnosed with HIV, and the overall transmitted drug resistance (TDR) prevalence was 9.5% (150 sequences). The regional prevalence of resistance according to Brazilian geographical regions was 9.4% in the northeast, 11.2% in the southeast, 6.8% in the central region, 10.2% in the north and 8.8% in the south. The inhibitor-specific TDR prevalence was 3.6% for nucleoside reverse transcriptase inhibitors (NRTIs), 5.8% for non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 1.6% for protease inhibitors (PIs); 1.0% of individuals presented resistance to more than one class of inhibitors. Overall, subtype B was more prevalent in every region except for the southern, where subtype C prevails. Conclusions: To the best of our knowledge, this is the first TDR study conducted in Brazil with nationwide representative sampling. The TDR prevalence revealed a moderate rate in the five Brazilian geographical regions, although some cities presented higher TDR prevalence rates, reaching 14% in Sao Paulo, for example. These results further illustrate the importance of surveillance studies for designing future strategies in primary antiretroviral therapy, aiming to mitigate TDR, as well as for predicting future trends in other regions of the globe where mass antiretroviral (ARV) treatment was implemented.
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