Pretreatment HIV-1 drug resistance in Argentina: results from a surveillance study performed according to WHO-proposed new methodology in 2014-15
| Autor: | María Belén Bouzas, C. Falistocco, Emiliano Bissio, Horacio Salomón, Silvia Kademian, L. Mammana, Giovanni Ravasi, S. Fernández Giuliano, M. L. Suárez Ornani, Analía Cudolá, Inés Zapiola, M. Vila, María G. Barbás, L. Espínola |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male Surveillance study Anti-HIV Agents Otras Ciencias Biológicas Population Prevalence Human immunodeficiency virus (HIV) Argentina HIV Infections Drug resistance medicine.disease_cause Ciencias Biológicas 03 medical and health sciences 0302 clinical medicine Drug Resistance Viral Thymidine Monophosphate Medicine Humans Pharmacology (medical) National level 030212 general & internal medicine education Pharmacology ARGENTINA education.field_of_study business.industry HIV TREATMENT 030112 virology Virology CD4 Lymphocyte Count AIDS Infectious Diseases Cross-Sectional Studies HIV-1 Reverse Transcriptase Inhibitors Christian ministry Female business CIENCIAS NATURALES Y EXACTAS HIV drug resistance Demography |
| Zdroj: | The Journal of antimicrobial chemotherapy. 72(2) |
| ISSN: | 1460-2091 |
| Popis: | Background: In Argentina, current national guidelines recommend starting with NNRTI-based regimens. Recently, there have been some local reports regarding concerning levels of NNRTI-transmitted resistance, but surveillance has never been carried out at a national level. Objectives: To determine the prevalence of HIV drug resistance in people starting ART in Argentina using a WHOproposed methodology. Methods: This was a cross-sectional, nationally representative study. Twenty-five antiretroviral-dispensing sites throughout the country were randomly chosen to enrol at least 330 persons starting ART, to generate a point prevalence estimate of resistance-associated mutations (RAMs) with a 5% CI (for the total population and for those without antiretroviral exposure). All consecutive patients older than 18 years starting or restarting ART in the chosen clinics were eligible. Samples were processed with Trugene and analysed using the Stanford algorithm. Results: Between August 2014 and March 2015, we obtained 330 samples from people starting ART. The mean±SD age was 35±11 years, 63.4% were male, 16.6% had prior antiretroviral exposure and the median (IQR) CD4 count was 275 cells/mm3 (106-461). The prevalence of RAMs found was 14% (±4%) for the whole population (3% NRTI-RAMs; 11% NNRTI-RAMs and 2%PI-RAMs) and 13% (+4%) for those without prior antiretroviral exposure (3%, 10% and 2%, respectively). The most common mutation was K103N. Conclusions: This surveillance study showed concerning levels of HIV drug resistance in Argentina, especially to NNRTIs. Due to this finding, Argentina´s Ministry of Health guidelines will change, recommending performing a resistance test for everyone before starting ART. If this is taken up properly, it also might function as a continuing surveillance tool. Fil: Bissio, E.. Fundación Centro de Estudios Infectológicos; Argentina Fil: Barbás, M. G.. Laboratorio Central de Córdoba; Argentina Fil: Bouzas, M. B.. Hospital Muñiz; Argentina Fil: Cudola, A.. Laboratorio Central de Córdoba; Argentina Fil: Salomon, Horacio Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina Fil: Espínola, L.. Provincia de Buenos Aires. Ministerio de Salud; Argentina Fil: Fernández Giuliano, S.. Hospital Muñiz; Argentina Fil: Kademián, S.. Laboratorio Central de Córdoba; Argentina Fil: Mammana, L.. Hospital Muñiz; Argentina Fil: Suarez Ornani, M. L.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina Fil: Ravasi, G.. Organización Panamericana de la Salud; Estados Unidos Fil: Vila, M.. Organización Panamericana de la Salud; Argentina Fil: Zapiola, I.. Hospital Muñiz; Argentina Fil: Falistocco, C.. Provincia de Buenos Aires. Ministerio de Salud; Argentina |
| Databáze: | OpenAIRE |
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