Brazilian Network for HIV Drug Resistance Surveillance: a survey of individuals recently diagnosed with HIV

Journal of the International AIDS Society - Tập 12 Số 1 - Trang 20-20 - 2009
Lilian A. Inocêncio1, Anderson Alvarenga Pereira1, Maria Cecília Araripe Sucupira2, José Carlos Couto-Fernandez3, Célia P Jorge4, Denise F. C. Souza1, H Fink5, Ricardo Sobhie Diaz2, Irina Marieta Becker6, Theodoro Armando Süffert7, Monica Barcelos Arruda8, Olinda Macêdo8, Mariângela Simão1, Amílcar Tanuri8
1Brazilian DST/AIDS Program, Ministry of Health, Brasilia, DF, Brazil
2Lab de Retrovirologia, UNIFESP, Sao Paulo, SP, Brasil
3Lab de Imunologia, IOC-FIOCRUZ, RJ, Brazil
4Laboratório de Biologia Molecular, UFBA, Salvador, BA, Brazil
5Public Health Lab (LACEN) Brasilia, DF, Brazil
6Public Health Lab (LACEN), Porto Alegre, RS, Brazil
7Health Center Porto, Municipatility of Porto Alegre, Porto Alegre, RS, Brazil
8Lab Virologia Molecular, IB-UFRJ, Rio de Janeiro, RJ, Brazil

Tóm tắt

Use of antiretrovirals is widespread in Brazil, where more than 200,000 individuals are under treatment. Although general prevalence of primary antiretroviral resistance in Brazil is low, systematic sampling in large metropolitan areas has not being performed.The HIV Threshold Survey methodology (HIV‐THS, WHO) was utilized, targeting Brazil's four major regions and selecting the six most populated state capitals: Sao Paulo, Rio de Janeiro, Salvador, Porto Alegre, Brasilia and Belem. We were able to sequence samples from 210 individuals with recent HIV diagnosis, 17 of them (8.1%) carrying HIV isolates with primary antiretroviral resistance mutations. Five, nine and four isolates showed mutations related to resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non‐nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs), respectively. Using HIV‐THS, we could find an intermediate level of transmitted resistance (5% to 15%) in Belem/Brasilia, Sao Paulo and Rio de Janeiro. Lower level of transmitted resistance (<5%) were observed in the other areas. Despite the extensive antiretroviral exposure and high rates of virologic antiretroviral failure in Brazil, the general prevalence of primary resistance is still low. However, an intermediate level of primary resistance was found in the four major Brazilian cities, confirming the critical need to start larger sampling surveys to better define the risk factors associated with transmission of resistant HIV.

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Journal of the International AIDS Society

Tập 12 Số 1

20-20

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