Article
Antiretroviral drug resistance in a respondent-driven sample of HIV-infected men who have sex with men in Brazil
Registro en:
BERMÚDEZ-AZA, E. H. et al. Antiretroviral Drug Resistance in a Respondent-Driven Sample of HIV-Infected Men Who Have Sex with Men in Brazil. Journal of Acquired Immune Deficiency Syndromes (1999), v. 57 Suppl 3, p. S186-192, ago. 2011.
1944-7884
10.1097/QAI.0b013e31821e9c36
Autor
Bermúdez-Aza, Elkin Hernan
Kerr, Ligia Regina Franco Sansigolo
Kendall, Carl
Pinho, Adriana Araujo
Mello, Maeve Brito de
Mota, Rosa Salani
Guimarães, Mark Drew Crosland
Alencar, Cecilia Salete
Brito, Ana Maria de
Dourado, Ines Costa
Batista, Sonia Maria da
Abreu, Fabiano
Oliveira, Lisangela Cristina de
Moraes, Adão Souza de
Benzaken, Adele Schwartz
Merchan-Hamann, Edgar
Freitas, Gisele Maria Brandão de
McFarland, Willi
Albuquerque, Elizabeth
Rutherford, George W.
Sabino, Ester
Resumen
*Universidade Federal de São Paulo, São Paulo, Brazil; †Universidade
Federal do Ceará; ‡Tulane University School of Public Health and
Tropical Medicine, New Orleans, LA; §Escola Nacional de Saúde
Pública/Fiocruz; kCICT/Fiocruz; {Universidade Federal de Minas Gerais;
**Centro de Pesquisas Aggeu Magalhães/Fiocruz; ††Instituto de Saúde
Coletiva/Universidade Federal da Bahia; ‡‡Universidade Federal do Rio
de Janeiro, Rio de Janeiro, Brazil; §§Secretaria Municipal de Saúde de
Santos; kkUniBrasil; {{Secretaria Municipal de Saúde de Itajaí;
***Fundação Alfredo da Matta; †††Universidade de Brasília;
‡‡‡Secretaria Municipal de Saúde de Campo Grande; §§§University of
California, San Francisco; and kkkLIM 03, Universidade de São Paulo,
São Paulo, Brazil. Departamento de DST, AIDS
Hepatites Virais do Ministério da Saúde (CSV 234/07) e
FAPESP - Fundação de Amparo a Pesquisa do Estado de São Paulo
Paulo (2004 / 15856-9) e CAPES. Background: There are few studies on HIV subtypes and primary
and secondary antiretroviral drug resistance (ADR) in communityrecruited
samples in Brazil. We analyzed HIV clade diversity and
prevalence of mutations associated with ADR in men who have sex
with men in all five regions of Brazil.
Methods: Using respondent-driven sampling, we recruited 3515
men who have sex with men in nine cities: 299 (9.5%) were HIVpositive;
143 subjects had adequate genotyping and epidemiologic
data. Forty-four (30.8%) subjects were antiretroviral therapyexperienced
(AE) and 99 (69.2%) antiretroviral therapy-naı¨ve
(AN). We sequenced the reverse transcriptase and protease regions
of the virus and analyzed them for drug resistant mutations using
World Health Organization guidelines.
Results: The most common subtypes were B (81.8%), C (7.7%),
and recombinant forms (6.9%). The overall prevalence of primary ADR resistance was 21.4% (i.e. among the AN) and secondary ADR
was 35.8% (i.e. among the AE). The prevalence of resistance to
protease inhibitors was 3.9% (AN) and 4.4% (AE); to nucleoside
reverse transcriptase inhibitors 15.0% (AN) and 31.0% (AE) and to
nonnucleoside reverse transcriptase inhibitors 5.5% (AN) and 13.2%
(AE). The most common resistance mutation for nucleoside reverse
transcriptase inhibitors was 184V (17 cases) and for nonnucleoside
reverse transcriptase inhibitors 103N (16 cases).
Conclusions: Our data suggest a high level of both primary and
secondary ADR in men who have sex with men in Brazil. Additional
studies are needed to identify the correlates and causes of
antiretroviral therapy resistance to limit the development of resistance
among those in care and the transmission of resistant strains in the
wider epidemic. 2050-01-01