Resistance rates among antiretroviral regimens in pregnant people living with HIV.

Autor: da Silveira Gouvêa MIF; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., de Lourdes Benamor Teixeira M; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Fuller T; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.; University of California Los Angeles, Institute of the Environment and Sustainability, Los Angeles, California, USA., Sodré MCMP; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., Medeiros AF; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., de Mattos Salgueiro M; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., da Silveira Bressan C; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.; University of California Los Angeles, Institute of the Environment and Sustainability, Los Angeles, California, USA., Braga CM; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., da Silva PA; Maternal Fetal Unit, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., Mendes-Silva W; Maternal Fetal Unit, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., Moreira C; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., Jundi F; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., Cruz ML; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., Ceci L; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., Lattanzi FP; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., João EC; Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: HIV medicine [HIV Med] 2023 Sep; Vol. 24 (9), pp. 1020-1025. Date of Electronic Publication: 2023 May 04.
DOI: 10.1111/hiv.13498
Abstrakt: Objectives: To update nucleoside reverse transcriptase inhibitor (NRTI), nonnucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI) resistance rates and describe the frequency of HIV subtypes in a cohort of pregnant people living with HIV (PPLH) at a national Prevention of Mother-To-Child HIV Transmission (PMTCT) centre.
Methods: We evaluated genotypic resistance among PPLH during prenatal care who were antiretroviral therapy-naïve or experienced. We determined mutations by the Surveillance of Drug Resistance Mutations (SDRM) dataset and also focused on studying participants with intermediate or high resistance defined through the Stanford score.
Results: From 2018 to 2021, 1170 PPLH received prenatal care at the centre and 550 were genotyped. Among the 295 SDRMs, with respect to NRTI resistance mutations, there were 27/295 (9.2%) M184V/I, 14/295 (4.7%) T215Y/C/D/E/F/V/I/S and 12/295 (4.1%) M41L. For NNRTI, there were 75/295 (25.4%) K103N, 18/295 (6.1%) M230L and 14/295 (4.7%) G190A/E/S mutations. For PI, the most frequent mutations were 13/295 (4.4%) V82A/S/F/T, 12/295 (4.1%) M46I/L and 10/295 (3.4%) D30N. Based on the Stanford score, 36/224 (16%) naïve participants had one or more antiretroviral resistance mutations, 81% of whom had NNRTI resistance. In the treatment-experience group, 108/326 (33%) had one or more mutations, 91% of whom had NNRTI resistance. The most frequent HIV subtype was B (82.5%).
Conclusions: Our findings suggest that continuous surveys of HIV genotype appear to be important tools to map the distribution and evolution of HIV subtypes and resistance to provide information to support treatment policies. Furthermore, concerns about the use of rilpivirine-containing regimens underscore the importance of resistance surveillance.
(© 2023 British HIV Association.)
Databáze: MEDLINE
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