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https://www.arca.fiocruz.br/handle/icict/46339
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PreprintDireito Autoral
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- INI - Preprint [77]
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PREVALENCE OF PRIMARY RESISTANCE AMONG ACUTELY/RECENTLY HIV INFECTED PATIENTS IN RIO DE JANEIRO, BRAZIL
Autor(es)
Afiliação
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Resumo em Inglês
Introduction: 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.
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