Antiretroviral Drug Resistance Among Patients With Human Immunodeficiency Virus Who Act as Sources or Potential Sources in Occupational Accidents Involving Healthcare Workers

El-Far, Fabiane; Medeiros, Eduardo Alexandrino; Gasparoto, Carlos Teodoro; Diaz, Ricardo Sobhie

doi:10.1086/502617

Cited by 7 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the patient had been treated for a long period of time with ZDV immunotherapy, it is currently known that the Nucleoside Analog Mutations selected by this drug can confer varying degrees of reduced susceptibility (cross resistance) to all nucleoside and nucleotide analogues reverse transcriptase inhibitors tested to-date [61] . These data and other showing that sources or potential source in occupational accidents involving health care works have antiretroviral resistant HIV [62] , support guidelines recommending the use of HAART for post exposure prophylaxis in health care workers. The transmission of a virus containing genetic markers of resistance from an antiretroviral experienced patient also supports guidelines that take into consideration the medical history of the patient and antiviral response profiles of the source patients' virus when deciding on antiretroviral prophylaxis in postexposure settings [4] .…”

Section: Discussionsupporting

confidence: 66%

Passive Transfer of HIV-1 Antibodies and Drug Resistant Virus during a Health Care Worker Accident: Implications for HCW Post-Exposure Management

Oliveira¹,

Diaz²,

Harmache³

et al. 2008

American J. of Infectious Diseases

Self Cite

View full text Add to dashboard Cite

Problem statement:We studied in detail a case in which a nurse caring for an HIV-infected child suffered a deep-laceration accident with contaminated blood. Approach: The patient had been treated with zidovudine (ZDV) and the nurse became infected despite prophylactic use of ZDV initiated 2 h after the accident. A reactive anti-HIV-1/2 EIA and an indeterminate western blot (gp120/160 reactivity) were obtained from the nurse on the day of the accident, suggesting preexposure infection. However, a negative western blot and positive DNA PCR were documented 10 days after the accident and seroconversion occurred an additional two weeks later. Results: Phylogenetic analyses of HIV-1 tat and C2-C4-gp120 env regions confirmed that the nurse infected by two different HIV-1 strains present in the child. Strains present in both subjects revealed multinucleoside resistant HIV-1. Dilutional serological studies using 10 HIV-infected patients' sera demonstrated that passive seroreactivity could occur with infusion of less than 1 uL of blood when highly sensitive assays are employed. Conclusion: This is the first well-documented case of passive HIV antibody detection after a percutaneous exposure. Reactive baseline serology should not be assumed to represent prior infection nor exclude prophylaxis. Transmission of drug-resistant HIV-1 corroborates the medical history and supports use of drug history and resistance testing to guide antiretroviral prophylaxis.

show abstract

Section: Discussionsupporting

confidence: 66%

Passive Transfer of HIV-1 Antibodies and Drug Resistant Virus during a Health Care Worker Accident: Implications for HCW Post-Exposure Management

Oliveira¹,

Diaz²,

Harmache³

et al. 2008

American J. of Infectious Diseases

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, studies have demonstrated the emergence of drug-resistant HIV in source patients of occupational exposures and this raises concerns over the use of fewer medications. An observational study conducted in Brazil found that .41% of source patients had resistancerelated mutations in reverse transcriptase, protease or both [30]. Another study of source patients to occupational exposure based in America also found an approximate 40% prevalence of mutations associated with resistance to reverse transcriptase and PIs [31].…”

Section: Prescription Of Pepmentioning

confidence: 99%

Occupational exposure to HIV and the use of post-exposure prophylaxis

Hamlyn

Easterbrook

2007

Occupational Medicine

View full text Add to dashboard Cite

show abstract

“…[18][19][20][21][22][23][24] Increasing rates of resistance may not only limit future therapeutic options, but also affect HAART efficacy, even under postexposure prophylaxis. 25,26 Thus, resistance testing before initiation of therapy may be of value in selected sites to help determine the most appropriate ARV combination regimen. More than a decade ago, Brazil was the first nation to offer universal and free access to ARV drugs to HIV-positive persons.…”

Section: Introductionmentioning

confidence: 99%

Primary Antiretroviral Drug Resistance among HIV Type 1-Infected Individuals in Brazil

Sprinz

Netto

Lima

et al. 2009

AIDS Research and Human Retroviruses

View full text Add to dashboard Cite

Infection with drug-resistant human immunodeficiency virus type 1 (HIV-1) has been documented in all countries that have surveyed for it and may result in an unfavorable response to therapy. The prevalence and characteristics of individuals with transmitted resistance to antiretroviral drugs have been scarcely described in Brazil. We performed antiretroviral resistance testing prior to initiation of therapy in 400 subjects enrolled from 20 centers in 13 Brazilian cities between March and September 2007. Genotyping was conducted using PCR-amplified HIV pol products by automated sequencing, and genotype interpretation was done according to the IAS-USA consensus. Of 400 eligible participants, 387 (95.8%) were successfully tested. Seven percent of antiretroviral-naive patients carried viruses with one or more major mutation associated with drug resistance. The prevalence of these mutations was 1.0% for protease inhibitors, 4.4% for nonnucleoside reverse transcriptase inhibitors, and 1.3% for nucleoside reverse transcriptase inhibitors. The frequency of multidrug resistance among the resistant strains was 13.6%. Among subjects infected with drug-resistant virus, the majority were infected with subtype B viruses (91%). Subjects from the city of São Paulo had higher transmitted resistance mutations compared to the rest of the country. Reporting a partner taking antiretroviral medications was associated with a higher chance of harboring HIV variants with major drug resistance mutations [odds ratio = 2.57 (95% confidence interval, 1.07-6.16); p = 0.014]. Resistance testing in drug-naive individuals identified 7% of subjects with mutations associated with reduced susceptibility to antiretroviral drugs. Continued surveillance of drug-resistant HIV-1 in Brazil is warranted when guidelines for HIV prophylaxis and treatment are updated. Resistance testing among drug-naive patients prior to treatment initiation should be considered, mainly directed at subjects whose partners are already on antiretroviral therapy.

show abstract

Antiretroviral Drug Resistance Among Patients With Human Immunodeficiency Virus Who Act as Sources or Potential Sources in Occupational Accidents Involving Healthcare Workers

Cited by 7 publications

References 12 publications

Passive Transfer of HIV-1 Antibodies and Drug Resistant Virus during a Health Care Worker Accident: Implications for HCW Post-Exposure Management

Passive Transfer of HIV-1 Antibodies and Drug Resistant Virus during a Health Care Worker Accident: Implications for HCW Post-Exposure Management

Occupational exposure to HIV and the use of post-exposure prophylaxis

Primary Antiretroviral Drug Resistance among HIV Type 1-Infected Individuals in Brazil

Contact Info

Product

Resources

About