Prevalence of antiretroviral drug resistance among treatment-naive and treated HIV-infected patients in Venezuela

Rangel, Héctor R.; Garzaro, Domingo; Torres, Jaime R.; Castro, Julio; Suárez, José Antonio; Naranjo, Laura; Ossenkopp, John; Martínez, Nahir; Gutiérrez, Cristina; Pujol, Flor H.

doi:10.1590/s0074-02762009000300020

Cited by 8 publications

(5 citation statements)

References 17 publications

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“…These results indicate that the HIV-1 molecular epidemiologic profile observed in Roraima is much more homogenous than that described in any other Brazilian state, even from the Northern region [8,18,29–33], but comparable to that described in the neighboring country of Venezuela [34,35]. Roraima is one of the most isolated Brazilian states, being connected by land only to the state of Amazonas.…”

Section: Discussionsupporting

confidence: 49%

HIV-1 genetic diversity and antiretroviral drug resistance among individuals from Roraima state, northern Brazil

et al. 2017

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The HIV-1 epidemic in Brazil has spread towards the Northern country region, but little is known about HIV-1 subtypes and prevalence of HIV strains with resistance mutations to antiretrovirals in some of the Northern states. HIV-1 protease (PR) and reverse transcriptase (RT) sequences were obtained from 73 treatment-naive and -experienced subjects followed between 2013 and 2014 at a public health reference unit from Roraima, the northernmost Brazilian state. The most prevalent HIV-1 clade observed in the study population was the subtype B (91%), followed by subtype C (9%). Among 12 HIV-1 strains from treatment-naïve patients, only one had a transmitted drug resistance mutation for NNRTI. Among 59 treatment-experienced patients, 12 (20%) harbored HIV-1 strains with acquired drug resistance mutations (ADRM) that reduce the susceptibility to two classes of antiretroviral drugs (NRTI and NNRTI or NRTI and PI), and five (8%) harbored HIV-1 strains with ADRM that reduced susceptibility to only one class of antiretroviral drugs (NNRTI or PI). No patients harboring HIV strains with reduced susceptibility to all three classes of antiretroviral drugs were detected. A substantial fraction of treatment-experienced patients with (63%) and without (70%) ADRM had undetectable plasma viral loads (<40 copies/ml) at the time of sampling. Among treatment-experienced with plasma viral loads above 2,000 copies/ml, 44% displayed no ADRM. This data showed that the HIV-1 epidemic in Roraima displayed a much lower level of genetic diversity and a lower prevalence of ADRM than that described in other Brazilian states.

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Section: Discussionsupporting

confidence: 49%

HIV-1 genetic diversity and antiretroviral drug resistance among individuals from Roraima state, northern Brazil

et al. 2017

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“…In Venezuela, older studies performed mainly in Caracas, reported low-level or borderline moderate overall TDR: 3.2% (n = 31, 1999) [ 52 ]; 5.0% (n = 20, 2003) [ 53 ], all NRTI TDR cases. More recent studies showed an increase to moderate TDR levels: 11.0% (n = 63, 2004–2007) [ 54 ]; 6.5% (n = 62, 2008) [ 40 ]. TDR cases were mostly associated with NRTI; however, NNRTI and PI TDR were also observed ( Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

Surveillance of HIV Transmitted Drug Resistance in Latin America and the Caribbean: A Systematic Review and Meta-Analysis

Ávila‐Ríos¹,

Sued

Rhee

et al. 2016

PLoS ONE

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BackgroundHIV transmitted drug resistance (TDR) remains at moderate level in Latin America and the Caribbean (LAC). However, different epidemiologic scenarios could influence national and sub-regional TDR levels and trends.Methods and FindingsWe performed a systematic review of currently available publications on TDR in antiretroviral treatment-naïve adults in LAC. Ninety-eight studies published between January 2000 and June 2015 were included according to critical appraisal criteria and classified by sub-region: Brazil (50), Mesoamerica (17), Southern Cone (16), Andean (8) and Caribbean (7). From these, 81 studies encompassing 11,441 individuals with data on DR mutation frequency were included in a meta-analysis. Overall TDR prevalence in LAC was 7.7% (95% CI: 7.2%-8.2%). An increasing trend was observed for overall TDR when comparing 2000–2005 (6.0%) and 2006–2015 (8.2%) (p<0.0001), which was associated with significant NNRTI TDR increase (p<0.0001). NRTI TDR decreased (4.5% vs. 2.3%, p<0.0001). NNRTI TDR increase was associated mainly with K101E, K103N and G190A. NRTI TDR decrease was associated mainly with M184V, K70R and T215Y. All sub-regions reached moderate overall TDR levels. The rapid increase in TDR to all antiretroviral classes in the Caribbean is notable, as well as the significant increase in NNRTI TDR reaching moderate levels in the Southern Cone. NRTI TDR was dominant in 2000–2005, mainly in the Caribbean, Mesoamerica and Brazil. This dominance was lost in 2006–2015 in all sub-regions, with the Southern Cone and the Caribbean switching to NNRTI dominance. PI TDR remained mostly constant with a significant increase only observed in the Caribbean.ConclusionsGiven the high conceptual and methodological heterogeneity of HIV TDR studies, implementation of surveys with standardized methodology and national representativeness is warranted to generate reliable to inform public health policies. The observed increasing trend in NNRTI TDR supports the need to strengthen TDR surveillance and programme monitoring and evaluation in LAC.

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“…Primary drug resistance mutations to protease and reverse transcriptase inhibitors are found in around 11% of treatment-naive patients. 2 A new group of polymerase inhibitors, integrase inhibitors, has been added to the HAART arsenal. 3 This new type of drug has recently been introduced in the country.…”

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Absence of Primary Integrase Resistance Mutations in HIV Type 1-Infected Patients in Venezuela

Rangel

Garzaro

Fabbro

et al. 2010

AIDS Research and Human Retroviruses

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The preexistence of mutations to integrase inhibitors in HIV-1-infected Venezuelan patients was evaluated. The integrase region of the HIV-1 genome was amplified by nested-PCR and sequenced in 57 isolates from both naive (n = 24) and treated patients who received protease and/or reverse transcriptase inhibitors (PI and RTI, n = 33), but were never exposed to integrase inhibitors. Only one primary integrase resistance mutation, not conferring drug resistance by itself, was found among these patients, although several minor viral mutations, equally distributed among naive and PI- and RTI-treated patients, were also found. In the limited number of samples, no relation was found among the presence of resistance mutations to PI or RTI and the presence of minor mutations to integrase. The absence of resistance to integrase inhibitors may be related to the recent introduction of these drugs in our country. The availability of in-house assays allows for a more comprehensive surveillance of drug resistance to integrase inhibitors in Venezuela.

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Prevalence of antiretroviral drug resistance among treatment-naive and treated HIV-infected patients in Venezuela

Cited by 8 publications

References 17 publications

HIV-1 genetic diversity and antiretroviral drug resistance among individuals from Roraima state, northern Brazil

HIV-1 genetic diversity and antiretroviral drug resistance among individuals from Roraima state, northern Brazil

Surveillance of HIV Transmitted Drug Resistance in Latin America and the Caribbean: A Systematic Review and Meta-Analysis

Absence of Primary Integrase Resistance Mutations in HIV Type 1-Infected Patients in Venezuela

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