Prevalence of primary resistance among acutely/recently HIV infected patients in Rio de Janeiro, Brazil

dc.creatorFerreira, Ana Cristina G.
dc.creatorCoelho, Lara E.
dc.creatorGrinsztejn, Eduarda
dc.creatorJesus, Carlos S. de
dc.creatorGuimarães, Monick L.
dc.creatorVeloso, Valdiléa G.
dc.creatorGrinsztejn, Beatriz
dc.creatorCardoso, Sandra W.
dc.date2021-03-11T15:34:16Z
dc.date2021-03-11T15:34:16Z
dc.date2017
dc.date.accessioned2023-09-26T20:32:54Z
dc.date.available2023-09-26T20:32:54Z
dc.identifierFERREIRA, Ana Cristina G. et al. Prevalence of primary resistance among acutely/recently HIV infected patients in Rio de Janeiro, Brazil. The Brazilian Journal of Infectious Diseases, v. 21, n. 4, p. 1-6, 2017
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/46339
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8859277
dc.descriptionIntroduction: The widespread use of antiretroviral therapy (ART) increased the transmission of antiretroviral resistant HIV strains. ART initiation during acute/recent HIV infection limits HIV reservoirs and improves immune response in HIV infected individuals. Transmitted drug resistance (TDR) may jeopardize the early goals of early ART among acute/recent HIV infected patients. Methods: Patients with acute/recent HIV infection who underwent resistance test before ART initiation were included in this analysis. HIV-1 sequences were obtained using an in house protease/reverse transcriptase genotyping assay. TDR was identified according to the Stanford HIV Database for Transmitted Drug Resistance Mutations, based on WHO 2009 surveillance list, and HIV-1 subtyping according to Rega HIV-1 subtyping tool. Comparison between patients with and without TDR was made using Kruskal–Wallis and Chi-square tests. Results: Forty-three patients were included, 13 with acute HIV infection and 30 with recent HIV infection. The overall TDR prevalence was 16.3% (95% confidence interval [CI]: 8.1–30.0%). The highest prevalence of resistance (11.6%, 95% CI: 8.1–24.5) was against nonnucleoside reverse transcriptase inhibitors (NNRTI), and K103N was the most frequently identified mutation. Conclusions: The high prevalence of NNRTI resistance indicates that efavirenz-based regimen without prior resistance testing is not ideal for acutely/recently HIV-infected individuals in our setting. In this context, the recent proposal of including integrase inhibitors as a first line ART regimen in Brazil could be an advantage for the treatment of newly HIV infected individuals. However, it also poses a new challenge, since integrase resistance test is not routinely performed for ART naive individuals. Further studies on TDR among acutely/recently HIV-infected are needed to inform on predictors of TDR and ART outcomes among these population.
dc.formatapplication/pdf
dc.languageeng
dc.publisherElsevier
dc.rightsrestricted access
dc.subjectHIV
dc.subjectInfection
dc.subjectTransmission
dc.subjectPrimary resistance
dc.subjectAntiretroviral therapy
dc.titlePrevalence of primary resistance among acutely/recently HIV infected patients in Rio de Janeiro, Brazil
dc.typePreprint


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