Abstract

Prevalence of transmitted antiretroviral drug resistance in recently HIV infected individuals and newborns from Panama

J. Castillo¹, Y. Mendoza¹, A. Martinez¹, G. Artega¹, R. Samaniego², D. Estripeaut³, K.R. Page⁴, I.L. de Rivera⁵, J.M. Pascale¹, Gorgas Panama

¹Instituto Conmemorativo Gorgas de Estudios de la Salud, Genomica and Proteomica, Panama, Panama, ²Hospital Santo Tomas, Infectologia, Panama, Panama, ³Hospital del Niño, Infectologia, Panama, Panama, ⁴John Hopkins University, School of Medicine, Baltimore, United States, ⁵Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras

Background: Transmission of HIV drug resistance (TDR) gives rise to reduced efficacy of initial antiretroviral treatment and compromises the effectiveness of national prevention and control programs. Thus, epidemiological studies of resistance in recently infected patients have significant relevance for the selection of first-line and prophylactic ARV regimens in developing countries.
Methods: In this survey we used stored plasma samples from confirmed recently infected adults and HIV positive newborns collected from (years). Plasma was subjected to HIV genotyping analysis using an in house method. ARV mutations were determined and scored using the Stanford HIV Drug Resistance algorithm.
Results: Prevalence of mutations conferring resistance to RT inhibitors were 11.6% for adults and 11.5% for newborns. Protease gene polymorphisms observed had no clinical significance. Table# 1 describes the pattern of ARV resistance mutations for each study group. Only one neonate showed the K103N mutation.

Recently Infected Individuals (5/43)		Newborns (3/26)
NRTI (5/43)	NNRTI (3/43)	NRTI (2/26)	NNRTI (1/26)
F77F/L, L210W, A62V,T215L, M41L, K219E	K103N, E138A,Y181C, P225H	K219Q, T215Y	K103N

[Table # 1. ARV Resistance Mutations by Study group]


Conclusions: We found similar rates of TDR in recently infected patients and newborns. Consistent with findings in other settings, the M184V mutation, which confers resistance to 3TC and FTC, was not observed in any group. Resistance to NNRTI in a neonate is concerning since efavirenz or nevirapine are commonly used to prevent maternal to child transmission. The surveillance of TDR can help health authorities optimize HIV treatment algorithms in the country.
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