Antiretroviral drug resistance among patients with human immunodeficiency virus who act as sources or potential sources in occupational accidents involving healthcare workers

Antiretroviral drug resistance among patients with human immunodeficiency virus who act as sources or potential sources in occupational accidents involving healthcare workers

Author El-Far, Fabiane Autor UNIFESP Google Scholar
Medeiros, Eduardo Alexandrino Servolo de Autor UNIFESP Google Scholar
Gasparoto, Carlos Teodoro Autor UNIFESP Google Scholar
Diaz, Ricardo Sobhie Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Inst Infect Emilio Ribas
Infect Control Hosp Epidemiol
Abstract OBJECTIVE: To determine human immunodeficiency virus (HIV) type 1 genotypic antiretroviral drug resistance profiles of patients presenting a risk or potential risk for occupational exposure of healthcare workers.DESIGN: Observational survey involving HIV-infected patients. Blood samples collected from source-patients and potential source-patients underwent HIV-1 genotypic antiretroviral resistance testing and determination of CD4 counts and viral load. Affected healthcare workers were monitored for 6 months after exposure.SETTING: The survey was conducted in a tertiary-care hospital located in Sao Paulo, Brazil. Sao Paulo is considered the epicenter of the HIV-acquired immunodeficiency (AIDS) virus epidemic in Brazil.PARTICIPANTS: Source-patients, potential source-patients, and affected healthcare workers.RESULTS: A total of 371 occupational exposures to biological materials were reported, 46 (12.3%) of which were from HIV-seropositive source-patients. Samples from 18 source-patients and 26 patients considered potential sources for accidents were analyzed. Of these 44 samples, 18 (41%) presented resistance-related mutations in reverse transcriptase, protease, or both. Of these 18 samples, 16 (89%) had resistance to drugs included in the prophylactic schedule recommended by the Brazilian Ministry of Health.CONCLUSIONS: Use of the Centers for Disease Control and Prevention-Brazilian post-exposure prophylaxis regimen will result in the administration of antiretroviral agents to which the source HIV-1 isolate will often be resistant. Therefore, it would be advisable to carefully investigate the history of use of antiretroviral agents by source-patients and adjust the prophylactic therapy based on those data and, subsequently, the results of resistance testing.
Language English
Date 2005-09-01
Published in Infection Control And Hospital Epidemiology. Thorofare: Slack Inc, v. 26, n. 9, p. 782-788, 2005.
ISSN 0899-823X (Sherpa/Romeo, impact factor)
Publisher Slack Inc
Extent 782-788
Origin https://doi.org/10.1086/502617
Access rights Closed access
Type Article
Web of Science ID WOS:000232338900007
URI http://repositorio.unifesp.br/11600/43977

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