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