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Title: Antiretroviral drug resistance in a respondent-driven sample of HIV-infected men who have sex with men in Brazil
Authors: 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
Abstract: 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.
Keywords: HIV-1
Men who have sex with men
Respondent-driven sampling
Antiretroviral resistance
DeCS: Adulto
Substituição de aminoácidos
Anti-retrovirais / farmacologia
Anti-retrovirais / uso terapêutico
Análise de Cluster
Coleção de dados
Resistência a Medicamentos Virais
Infecções por HIV / fármaco terapia
Infecções por HIV / virologia
Protease do HIV / genética
Transcriptase reversa do HIV / genética
HIV-1 / classificação
HIV-1 / efeitos de drogas
HIV-1 / genética
HIV-1 / isolamento e purificação
Homossexualidade masculina
Dados de Sequencia Molecular
Mutação, Missense
Análise de Sequência, DNA
População urbana
Issue Date: 2011
Citation: 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.
Description: *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.
DOI: 10.1097/QAI.0b013e31821e9c36
ISSN: 1944-7884
Copyright: restricted access
Appears in Collections:PE - IAM - Artigos de Periódicos

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