Evaluation of the genotypic pattern of HIV-1 resistance in AIDS patients failing antiretroviral therapy

Bahia, Fabianna; Pedroso, Célia; Netto, Eduardo Martins; Figueiredo, Ricardo G.; Neto, Lauro Pinto; Brites, Carlos

doi:10.1590/s1413-86702004000400003

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…The majority of patients with VF were in WHO stages II and III, but no statistically significant association between WHO stages and VF was found. These results are similar to results reported in Brazil [54] and in many parts of Africa [19,23,55].…”

Section: Discussionsupporting

confidence: 92%

First-line antiretroviral treatment and virological response among HIV adult patients at an accredited HIV care center, Cameroon

et al. 2019

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Background: Viral load (VL) monitoring in the clinical follow-up of HIV patients to detect treatment failure is not routinely offered in Cameroon. The study was designed to characterize virological response on antiretroviral treatment (ART) among adults living with HIV and to identify predictors of virological failure (VF). Methods: Between November 2014 and January 2016, a prospective, population-based cohort study was conducted among HIV-positive adults under first-line treatment and monitored at the Accredited HIV Care Center (AHCC) of Laquintinie Hospital of Douala. Clinical and biological data at the initiation of ART were collected from patients' medical records. HIV VL at 12 and 24 months after the patient started treatment on ART were performed using quantitative real-time PCR protocol with the generic HIV Roche TaqMan assay. Descriptive and logistic regression analysis were performed in Stata SE11 version in data analysis. Results: Overall 150 (45.5%) of 330 adults living with HIV were tested with at least one VL, and of these patients, 51 (34.0%) were tested with two VL during the followed-up. The VF was observed in 13 of 51 (25.5%) patients and among them, 8 (61.5%) switched to second-line ART regimens. Thirty-five (68.6%) of the 51 patients had an undetectable VL at the first VL measurement, and seven (13.7%) patients subsequently developed viral load rebound (VLR) on tritherapy. Using a multivariate analysis, the risk of VF was seven times higher in HIV adults who did not respect the medication hours (OR = 7.38, 95%CI = 1.56-34.90, p = 0.012) and eleven times higher in patients with none or primary school education (OR = 11.38, 95% CI = 2.41-53.76, p = 0.002). Conclusion: Low education level and poor adherence are the main risk factors for VF. Strengthening therapeutic failure prevention strategies and routine VL surveillance would allow early detection of VF and contribute in achieving the third goal of UNAIDS which recommends "90-90-90" targets for People Living with HIV in resourcelimited settings.

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Section: Discussionsupporting

confidence: 92%

First-line antiretroviral treatment and virological response among HIV adult patients at an accredited HIV care center, Cameroon

et al. 2019

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“…Most of other Brazilian studies reported NNRTI prevalence of mutations of 30 to 55.4%. 21,23,25,26 In Santos, the overall NNRTI prevalence was not explicit, but K103N occurred in 52% of patients, whereas in these data from Paraná it was 43.4%. 27 At Brazilian Northeast region, the specifi c mutations were even higher, with 62% substitutions in codon 103, 38.7% in codon 190 and 181 in codon 29.2%.…”

Section: Discussionmentioning

confidence: 58%

“…23 In the other Brazilian studies, L90M was also the most frequent, present in 26 to 37% of the cases. 20,21,23,24,44 Compared with international data, these patients present lower prevalence of wild-type virus, probably because in other sites -where genotype was available earlier in the setting of virologic failure -more wild-type virus can be demonstrated. Other reason may be the lower exposure to less effective regimens, including less than two active agents.…”

Section: Discussionmentioning

confidence: 76%

“…21,23,25,26 Only one national study showed even higher prevalence of wildtype virus (15.3%). 20 The most prevalent mutation occurred at codon 184 (68.31%), as reported in São Paulo (64%), 24 Rio de Janeiro (67%), 23 and Northeast Brazil (66%).…”

Section: Discussionmentioning

confidence: 99%

“…20 From 2004 to 2007, many other authors showed data from the prevalence of antiretroviral resistance in adults from Bahia, São Paulo, Rio de Janeiro, Federal District and North Eastern states. [21][22][23][24][25][26][27] The aim of this study is to analyze the genotypic profile of patients tested for resistance in the Brazilian state of Paraná, in order to determine the frequency of RT and PR mutations among patients failing ART.…”

Section: Introductionmentioning

confidence: 99%

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HIV-1 genotypic resistance profile of patients failing antiretroviral therapy in Paraná, Brazil

Toledo¹,

Carvalho²,

Romagnoli³

et al. 2010

Braz J Infect Dis

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Antiretroviral therapy (ART) has reduced morbidity and mortality related to human immunodeficiency virus (HIV) infection, but in spite of this advance, HIV mutations decrease antiretroviral susceptibility, thus contributing to treatment failure in patients. Genotyping HIV-1 allows the selection of new drugs after initial drug failure. This study evaluated the genotypic profi le of HIV-1 isolates from treated (drug-experienced) patients in Paraná, Brazil. The prevalence of mutations in reverse transcriptase (RT) and protease (PR) genes were assessed. We analyzed 467 genotypes of patients with HIV-1 viral loads above 1,000 copies/mL. Mutations at HIV-1 RT and PR genes and previously used ART regimens were recorded. The most prevalent RT mutations were: 184V (68.31%), 215YF (51.6%), 103NS (46%), 41L (39.4%), 67N (38.54%), 210W (23.5%), 190ASE (23.2%), and 181C (17.4%). PR mutations were 90M (33.33%), 82ATFS (29%), 46I (26.8%) and 54V (22.2%). The prevalence of mutations was in line with previous national and international reports, except to nonnucleoside analogue reverse transcriptase inhibitors related mutations, which were more prevalent in this study. Previous exposure to antiretroviral drugs was associated with genotypic resistance to specifi c drugs, leading to treatment failure in HIV patients.

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HIV-1 genotypic resistance profile of patients failing antiretroviral therapy in Paraná, Brazil

Toledo

Carvalho

Romagnoli

et al. 2010

The Brazilian Journal of Infectious Diseases

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Antiretroviral therapy (ART) has reduced morbidity and mortality related to human immunodeficiency virus (HIV) infection, but in spite of this advance, HIV mutations decrease antiretroviral susceptibility, thus contributing to treatment failure in patients. Genotyping HIV-1 allows the selection of new drugs after initial drug failure. This study evaluated the genotypic profile of HIV-1 isolates from treated (drug-experienced) patients in Paraná, Brazil. The prevalence of mutations in reverse transcriptase (RT) and protease (PR) genes were assessed. We analyzed 467 genotypes of patients with HIV-1 viral loads above 1,000 copies/mL. Mutations at HIV-1 RT and PR genes and previously used ART regimens were recorded. The most prevalent RT mutations were: 184V (68.31%), 215YF (51.6%), 103NS (46%), 41L (39.4%), 67N (38.54%), 210W (23.5%), 190ASE (23.2%), and 181C (17.4%). PR mutations were 90M (33.33%), 82ATFS (29%), 46I (26.8%) and 54V (22.2%). The prevalence of mutations was in line with previous national and international reports, except to nonnucleoside analogue reverse transcriptase inhibitors related mutations, which were more prevalent in this study. Previous exposure to antiretroviral drugs was associated with genotypic resistance to specific drugs, leading to treatment failure in HIV patients.

show abstract

Evaluation of the genotypic pattern of HIV-1 resistance in AIDS patients failing antiretroviral therapy

Cited by 9 publications

References 22 publications

First-line antiretroviral treatment and virological response among HIV adult patients at an accredited HIV care center, Cameroon

First-line antiretroviral treatment and virological response among HIV adult patients at an accredited HIV care center, Cameroon

HIV-1 genotypic resistance profile of patients failing antiretroviral therapy in Paraná, Brazil

HIV-1 genotypic resistance profile of patients failing antiretroviral therapy in Paraná, Brazil

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