HIV-1 Antiretroviral Drug Resistance Mutations in Treatment Naïve and Experienced Panamanian Subjects: Impact on National Use of EFV-Based Schemes.

Autor: Mendoza Y; Direction of Research and Technological Development, Gorgas Memorial Institute for Health Studies, Panama City, Panama.; Department of Biotechnology, Acharya Nagarjuna University, Guntur City, India.; Department of Genetics and Molecular Biology, School of Biology, University of Panama, Panama City, Panama.; Institute for Scientific Research and High Technology Services of Panama, Panama City, Panama., Castillo Mewa J; Direction of Research and Technological Development, Gorgas Memorial Institute for Health Studies, Panama City, Panama., Martínez AA; Direction of Research and Technological Development, Gorgas Memorial Institute for Health Studies, Panama City, Panama.; Department of Biotechnology, Acharya Nagarjuna University, Guntur City, India.; Institute for Scientific Research and High Technology Services of Panama, Panama City, Panama., Zaldívar Y; Direction of Research and Technological Development, Gorgas Memorial Institute for Health Studies, Panama City, Panama., Sosa N; Direction of Research and Technological Development, Gorgas Memorial Institute for Health Studies, Panama City, Panama., Arteaga G; Department of Microbiology, School of Medicine, University of Panama, Panama City, Panama., Armién B; Direction of Research and Technological Development, Gorgas Memorial Institute for Health Studies, Panama City, Panama.; Facultad de Ciencias de la Salud, Universidad Interamericana de Panamá, Panama City, Panama., Bautista CT; Direction of Research and Technological Development, Gorgas Memorial Institute for Health Studies, Panama City, Panama., García-Morales C; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases (Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias), Mexico City, Mexico., Tapia-Trejo D; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases (Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias), Mexico City, Mexico., Ávila-Ríos S; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases (Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias), Mexico City, Mexico., Reyes-Terán G; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases (Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias), Mexico City, Mexico., Bello G; Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil., Pascale JM; Direction of Research and Technological Development, Gorgas Memorial Institute for Health Studies, Panama City, Panama.; Department of Microbiology, School of Medicine, University of Panama, Panama City, Panama.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2016 Apr 27; Vol. 11 (4), pp. e0154317. Date of Electronic Publication: 2016 Apr 27 (Print Publication: 2016).
DOI: 10.1371/journal.pone.0154317
Abstrakt: The use of antiretroviral therapy in HIV infected subjects prevents AIDS-related illness and delayed occurrence of death. In Panama, rollout of ART started in 1999 and national coverage has reached 62.8% since then. The objective of this study was to determine the level and patterns of acquired drug resistance mutations of clinical relevance (ADR-CRM) and surveillance drug resistance mutations (SDRMs) from 717 HIV-1 pol gene sequences obtained from 467 ARV drug-experienced and 250 ARV drug-naïve HIV-1 subtypes B infected subjects during 2007-2013, respectively. The overall prevalence of SDRM and of ADR-CRM during the study period was 9.2% and 87.6%, respectively. The majority of subjects with ADR-CRM had a pattern of mutations that confer resistance to at least two classes of ARV inhibitors. The non-nucleoside reverse transcriptase inhibitor (NNRTI) mutations K103N and P225H were more prevalent in both ARV drug-naïve and ARV drug-experienced subjects. The nucleoside reverse transcriptase inhibitor (NRTI) mutation M184V was more frequent in ARV drug-experienced individuals, while T215YFrev and M41L were more frequent in ARV drug-naïve subjects. Prevalence of mutations associated to protease inhibitors (PI) was lower than 4.1% in both types of subjects. Therefore, there is a high level of resistance (>73%) to Efavirenz/Nevirapine, Lamivudine and Azidothymidine in ARV drug-experienced subjects, and an intermediate to high level of resistance (5-10%) to Efavirenz/Nevirapine in ARV drug-naïve subjects. During the study period, we observed an increasing trend in the prevalence of ADR-CRM in subjects under first-line schemes, but not significant changes in the prevalence of SDRM. These results reinforce the paramount importance of a national surveillance system of ADR-CRM and SDRM for national management policies of subjects living with HIV.
Databáze: MEDLINE
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