Primary resistance of HIV to antiretrovirals among individuals recently diagnosed at voluntary counselling and testing centres in the metropolitan region of Recife, Pernambuco

Determining the prevalence and type of antiretroviral (ARV) resistance among ARV-naïve individuals is important to assess the potential responses of these individuals to first-line regimens. The prevalence of primary resistance and the occurrence of recent infections among individuals with human imm...

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Detalhes bibliográficos
Autores: Cavalcanti, Ana Maria Salustiano, Brito, Ana Maria de, Salustiano, Daniela Medeiros, Lima, Kledoaldo Oliveira de, Silva, Sirleide Pereira da, Diaz, Ricardo Sobhie [UNIFESP], Lacerda, Heloisa Ramos
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2012
País:Brasil
Recursos:Universidade Federal de São Paulo (UNIFESP)
Repositório:Repositório Institucional da UNIFESP
Idioma:inglês
OAI Identifier:oai:repositorio.unifesp.br:11600/7115
Acesso em linha:http://dx.doi.org/10.1590/S0074-02762012000400002
http://repositorio.unifesp.br/handle/11600/7115
Access Level:Acceso aberto
Palavra-chave:transmitted antiretroviral resistance
HIV subtype
Brazil
recent HIV infection
Descrição
Resumo:Determining the prevalence and type of antiretroviral (ARV) resistance among ARV-naïve individuals is important to assess the potential responses of these individuals to first-line regimens. The prevalence of primary resistance and the occurrence of recent infections among individuals with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) were identified among recently diagnosed patients at five sexually transmitted disease/AIDS testing and counselling centres in the metropolitan region of Recife (RMR), Pernambuco, Brazil, between 2007-2009. One-hundred and eight samples were analysed using the Calypte® BED assay. Males predominated (56%), as did patients aged 31-50 years. Twenty-three percent presented evidence of a recent HIV infection. The median CD4+ T lymphocyte count was 408 cells/mm³ and the median viral load was 3.683 copies/mL. The prevalence of primary resistance was 4.6% (confidence interval 95% = 1-8.2%) based on criteria that excluded common polymorphisms in accordance with the surveillance drug resistance mutation criteria. The prevalence of resistance to non-nucleoside reverse transcriptase, nucleoside/nucleotide reverse transcriptase and protease inhibitors were 3.8%, 1.5% and 0.8%, respectively. Fifty-seven percent of strains were from clade B, 37.7% were clade F and 3.1% were clade C; there were no statistically significant differences with respect to resistance between clades. Recent infection tended to be more common in men (p = 0.06) and in municipalities in the south of the RMR (Jaboatão dos Guararapes and Cabo de Santo Agostinho) (p = 0.046). The high prevalence of recent infection and the high prevalence of non-B strains in this poor Brazilian region merit further attention.