Brazilian network for HIV Drug Resistance Surveillance (HIV-BresNet): a survey of treatment-naive individuals

Brazilian network for HIV Drug Resistance Surveillance (HIV-BresNet): a survey of treatment-naive individuals

Author Arruda, Monica B. Google Scholar
Boullosa, Lidia T. Google Scholar
Cardoso, Cynthia C. Google Scholar
da Costa, Carolina M. Google Scholar
Alves, Carlos R. B. Google Scholar
de Lima, Shirlene T. S. Google Scholar
Kaminski, Helena T. Google Scholar
Aleixo, Agdemir W. Google Scholar
Esposito, Ana O. P. Google Scholar
Cavalcanti, Ana M. S. Google Scholar
Riedel, Maristela Google Scholar
Couto-Fernandez, Jose C. Google Scholar
Ferreira, Selma B. Google Scholar
de Oliveira, Ivi C. M. Google Scholar
Portal, Loreci E. Google Scholar
Wolf, Hilda H. C. Google Scholar
Fernandes, Sandra B. Google Scholar
Pardini, Maria I. de M. C. Google Scholar
Feiteiro, Manoel V. C. Google Scholar
Tolentino, Fernanda M. Google Scholar
Diaz, Ricardo Sobhie Autor UNIFESP Google Scholar
Lopes, Giselle I. S. L. Google Scholar
Francisco, Roberta B. L. Google Scholar
Veras, Nazle M. C. Google Scholar
Pires, Ana F. Google Scholar
Franchini, Miriam Google Scholar
Mesquita, Fabio Google Scholar
Tanuri, Amilcar Google Scholar
Abstract Introduction: In Brazil, more than 487,450 individuals are currently undergoing antiretroviral treatment. In order to monitor the transmission of drug-resistant strains and HIV subtype distribution in the country, this work aimed to estimate its prevalence and to characterize the nationwide pretreatment drug resistance in individuals recently diagnosed with HIV between 2013 and 2015. Methods: The HIV threshold survey methodology (HIV-THS, WHO) targeting antiretroviral-naive individuals with recent HIV diagnosis was utilized, and subjects were selected from 51 highly populated cities in all five Brazilian macroregions. The HIV pol genotypic test was performed by genomic sequencing. Results: We analysed samples from 1568 antiretroviral-naive individuals recently diagnosed with HIV, and the overall transmitted drug resistance (TDR) prevalence was 9.5% (150 sequences). The regional prevalence of resistance according to Brazilian geographical regions was 9.4% in the northeast, 11.2% in the southeast, 6.8% in the central region, 10.2% in the north and 8.8% in the south. The inhibitor-specific TDR prevalence was 3.6% for nucleoside reverse transcriptase inhibitors (NRTIs), 5.8% for non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 1.6% for protease inhibitors (PIs)

1.0% of individuals presented resistance to more than one class of inhibitors. Overall, subtype B was more prevalent in every region except for the southern, where subtype C prevails. Conclusions: To the best of our knowledge, this is the first TDR study conducted in Brazil with nationwide representative sampling. The TDR prevalence revealed a moderate rate in the five Brazilian geographical regions, although some cities presented higher TDR prevalence rates, reaching 14% in Sao Paulo, for example. These results further illustrate the importance of surveillance studies for designing future strategies in primary antiretroviral therapy, aiming to mitigate TDR, as well as for predicting future trends in other regions of the globe where mass antiretroviral (ARV) treatment was implemented.
Keywords HIV
HIV drug resistance
pretreatment HIV drug resistance
primary antiretroviral resistance
antiretroviral resistance
HIV Drug Resistance Surveillance
xmlui.dri2xhtml.METS-1.0.item-coverage Chichester
Language English
Sponsor Brazilian Ministry of Health
Grant number BMH: TC 298/12
Date 2018
Published in Journal Of The International Aids Society. Chichester, v. 21, n. 3, p. -, 2018.
ISSN 1758-2652 (Sherpa/Romeo, impact factor)
Publisher John Wiley & Sons Ltd
Extent -
Origin http://dx.doi.org/10.1002/jia2.25032
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000429006000001
URI https://repositorio.unifesp.br/handle/11600/55874

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