| Full text | |
| Author(s): Show less - |
Ozorio Coelho, Luana Portes
[1]
;
Matsuda, Elaine Monteiro
[2]
;
Nogueira, Roberta Schiavon
[3]
;
de Moraes, Monica Jacques
[4]
;
Jamal, Leda Fatima
[3]
;
Ramalho Madruga, Jose Valdez
[3]
;
Tancredi, Mariza Vono
[3]
;
Queiroz de Leao, Aline Carralas
[3]
;
Romero Soldi, Giselle de Faria
[1]
;
de Macedo Brigido, Luis Fernando
[1]
;
Colpas, Daniela Rodrigues
;
Cabral, Gabriela Bastos
;
Lopes, Giselle Ibete Silva Lopez
;
Campos, Norberto Camilo
;
Ribeiro, Isadora Coutinho
;
Ahagon, Cintia Mayumi
;
Teixeira, Guilherme Penteado
;
Ferreira, Joao Leandro de Paula
;
de Campos, Ivana Barros
;
Carvalho, Mariana
;
Gomes, Rafaella
;
Pinheiro, Flavia Gennari
;
Pereira, Jr., Luiz Carlos
;
Morejon, Karen
;
da Costa, Alvaro Furtado
;
Kalmar, Erika Maria do Nascimento
;
Nogui, Fabio Luis Nascimento
;
Mueller, Patricia Rady
;
Goulart, Silvia Pereira
;
Leme, Suzana Toledo da Silva
;
Workgrp, MIHR
Total Authors: 31
|
| Affiliation: | [1] Adolfo Lutz Inst, Ctr Virol, Lab Retrovirus, Nucleo Doencas Sanguineas Sexuais, Av Dr Arnaldo 355, BR-01246902 Sao Paulo, SP - Brazil
[2] AIDS Santo Andre, Programa IST, SP, Santo Andre - Brazil
[3] AIDS, DST, CRT, Sao Paulo, SP - Brazil
[4] Univ Estadual Campinas, Fac Ciencias Med, Campinas, SP - Brazil
Total Affiliations: 4
|
| Document type: | Journal article |
| Source: | ARCHIVES OF VIROLOGY; v. 164, n. 3, p. 699-706, MAR 2019. |
| Web of Science Citations: | 3 |
| Abstract | |
HIV-1 transmitted drug resistance (TDR) mutations may reduce the efficacy of antiretroviral therapy (ART), but pre-treatment testing to determine the virus genotype can improve the efficacy of ART. Unfortunately, issues related to cost and logistics of pre-treatment testing limit its use in resource-limited settings. We studied 596 ART-naive individuals who were newly diagnosed from 2014 to 2016 in SAo Paulo, Brazil, to evaluate TDR and virological outcome after 48weeks of genotype-guided therapy. One or more TDR (based on the WHO surveillance list) was observed in 10.9% (CI 95%, 8.6-13.6) of the sequences, the most common of which was the K103N mutation, which confers resistance to first-generation drugs of the non-nucleoside reverse transcriptase inhibitor (NNRTI) antiretroviral drug class. Dual-class (1%, 6/596) and triple-class (0.34%, 2/596) resistance were uncommon. After 48weeks of treatment with ART, infection was suppressed to below 200 copies/mL in most patients (95%), with full suppression (RNA target not detected) in 65%. The following characteristics at patient enrollment were independently associated with a lack of full suppression: CD4 T cell counts below 500 cells/mu L, viremia above 100,000 copies/mL, older age, and TDR to NNRTI. The rates of resistance were intermediate, but genotype-guided therapy resulted in high rates of viral suppression. The observed resistance profile should not be an obstacle to the use of the dolutegravir-based regimen now recommended in Brazil, but genotype testing may be warranted before initiating first-generation NNRTI-based regimens. (AU) | |
| FAPESP's process: | 16/14813-1 - Evaluation of molecular biology technology for plasma viremia detection to the identification and incorporation of patients at acute phase of HIV-1 infection |
| Grantee: | Ivana Barros de Campos |
| Support Opportunities: | Research Grants - Research in Public Policies for the National Health Care System (PP-SUS) |
| FAPESP's process: | 13/19441-7 - Identification and analysis of incident HIV-1 infection |
| Grantee: | Luís Fernando de Macedo Brígido |
| Support Opportunities: | Regular Research Grants |