Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en Chile

Background: The main cause of virological failure during AIDS treatment is the resistance to antiretroviral medications (ARV). Aim: To search for mutations associated with ARV resistance in recently HIV-1 infected patients naïve to treatment, in Chile. Material and Methods: Patients over 18 years ol...

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Autores principales:	AFANI S,ALEJANDRO, BELTRÁN B,CARLOS, GALLARDO O,ANA MARÍA, ROESSLER V,PATRICIA, ACEVEDO M,WILLIAM, VÁSQUEZ T,PATRICIA
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2010
Materias:	Antiretroviral therapy Drug resistance, Genotype
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000600002
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spelling	oai:scielo:S0034-988720100006000022010-08-31Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en ChileAFANI S,ALEJANDROBELTRÁN B,CARLOSGALLARDO O,ANA MARÍAROESSLER V,PATRICIAACEVEDO M,WILLIAMVÁSQUEZ T,PATRICIA Antiretroviral therapy Drug resistance, Genotype Background: The main cause of virological failure during AIDS treatment is the resistance to antiretroviral medications (ARV). Aim: To search for mutations associated with ARV resistance in recently HIV-1 infected patients naïve to treatment, in Chile. Material and Methods: Patients over 18 years old with HIV-1 infection, naïve to antiretroviral drugs before the study were included. Patients with CD4 cell counts less than 200 cells/mm³, viral load below 2.000 copies/mL or any condition indicative of advanced AIDS were excluded. Criteria for diagnosis of recent infection (< 18 months) were a previous negative test for HIV antibodies or a history of an acute retroviral syndrome in the past 18 months. Resistance to drugs was analyzed using the TRUGENEtm HIV-1 assay from Bayer and the OpenGene DNA sequencing system. Results: Ninety nine percent of patients had at least one mutation, 27% had 4 or more mutations, but high level resistance to ARV was found only in 2.7% of cases. Point mutations for non nucleoside reverse transcriptase inhibitors (NNRTI) were detected in 4.1% of cases (K103N in 1 patient, V179D in 2 patients), for nucleoside reverse transcriptase inhibitors (NRTI) in 8.1% of cases (T215S in 1 patient, V118I in 4 patients, M41L in 1 patient) and for protease inhibitors (PI) in 1.3% of cases. All mutations detected in the protease gene were secondary. Of these, the most common were L63P/T (38 patients), L10I/V (27 patients) and V77I (26 patients). Resistance to two or more antiretroviral classes was not detected. Conclusions: This study supports that, by now, primary resistance has a low prevalence in Chile. Therefore, a genotyping test before starting antiretroviral therapy is not necessary.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.138 n.6 20102010-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000600002es10.4067/S0034-98872010000600002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Antiretroviral therapy Drug resistance, Genotype
spellingShingle	Antiretroviral therapy Drug resistance, Genotype AFANI S,ALEJANDRO BELTRÁN B,CARLOS GALLARDO O,ANA MARÍA ROESSLER V,PATRICIA ACEVEDO M,WILLIAM VÁSQUEZ T,PATRICIA Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en Chile
description	Background: The main cause of virological failure during AIDS treatment is the resistance to antiretroviral medications (ARV). Aim: To search for mutations associated with ARV resistance in recently HIV-1 infected patients naïve to treatment, in Chile. Material and Methods: Patients over 18 years old with HIV-1 infection, naïve to antiretroviral drugs before the study were included. Patients with CD4 cell counts less than 200 cells/mm³, viral load below 2.000 copies/mL or any condition indicative of advanced AIDS were excluded. Criteria for diagnosis of recent infection (< 18 months) were a previous negative test for HIV antibodies or a history of an acute retroviral syndrome in the past 18 months. Resistance to drugs was analyzed using the TRUGENEtm HIV-1 assay from Bayer and the OpenGene DNA sequencing system. Results: Ninety nine percent of patients had at least one mutation, 27% had 4 or more mutations, but high level resistance to ARV was found only in 2.7% of cases. Point mutations for non nucleoside reverse transcriptase inhibitors (NNRTI) were detected in 4.1% of cases (K103N in 1 patient, V179D in 2 patients), for nucleoside reverse transcriptase inhibitors (NRTI) in 8.1% of cases (T215S in 1 patient, V118I in 4 patients, M41L in 1 patient) and for protease inhibitors (PI) in 1.3% of cases. All mutations detected in the protease gene were secondary. Of these, the most common were L63P/T (38 patients), L10I/V (27 patients) and V77I (26 patients). Resistance to two or more antiretroviral classes was not detected. Conclusions: This study supports that, by now, primary resistance has a low prevalence in Chile. Therefore, a genotyping test before starting antiretroviral therapy is not necessary.
author	AFANI S,ALEJANDRO BELTRÁN B,CARLOS GALLARDO O,ANA MARÍA ROESSLER V,PATRICIA ACEVEDO M,WILLIAM VÁSQUEZ T,PATRICIA
author_facet	AFANI S,ALEJANDRO BELTRÁN B,CARLOS GALLARDO O,ANA MARÍA ROESSLER V,PATRICIA ACEVEDO M,WILLIAM VÁSQUEZ T,PATRICIA
author_sort	AFANI S,ALEJANDRO
title	Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en Chile
title_short	Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en Chile
title_full	Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en Chile
title_fullStr	Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en Chile
title_full_unstemmed	Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en Chile
title_sort	prevalencia de resistencia primaria en pacientes con infección reciente por vih-1 en chile
publisher	Sociedad Médica de Santiago
publishDate	2010
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000600002
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Prevalencia de resistencia primaria en pacientes con infección reciente por VIH-1 en Chile

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