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2014, Number 4

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Rev cubana med 2014; 53 (4)

Resistance behavior to antiretroviral drugs in a Havana outpatient consultation in 2012

Díaz THM, Machado ZLY, Martínez FL, Ruiz GNM, Nibot SC, Valdés CN, Dubed EM, Blanco AM

Language: Spanish
References: 24
Page: 445-455
PDF size: 214.11 Kb.


ABSTRACT

Introduction: the emergence of resistant virus antiretroviral human immunodeficiency type 1 (HIV-1) is a major cause of treatment failure.
Objective: to analyze the mutations associated with antiretroviral resistance and resistance levels in a group of patients with failure criteria to antiretroviral therapy (HAART).
Methods: Plasma samples from 25 individuals with failure criteria to HAART were collected out of 157 HIV-1 positive patients attending the Outpatient Infectious Diseases at Hermanos Ameijeiras Hospital during 2012. The viral subtype and resistance mutations were determined; and the time between the beginning of the last therapy and detection of resistant viruses was estimated time.
Results: 52 % of patients had only received HAART regimen. Mutations associated with resistance in 84 % of patients were detected. 64 % had to antiretroviral treatment strategy employed as first high resistance in this country. The average time between the beginning of the last therapy and the detection of resistant viruses was 2.3 years. 16 % of patients had susceptible virus. The probability of non-adherence to HAART could be the cause of therapeutic failure in this group.
Conclusions: high levels of resistance to first-line HAART used in Cuba and the emergence of resistant variants after starting treatment were evident. These results emphasize the need for monitoring resistance as part of comprehensive care for people living with HIV/AIDS.


REFERENCES

  1. Hirsch MS, Brun-Vezinet F, Clotet B, Conway B, Kuritzkes DR, D’Aquila RT, et al. Antiretroviral drug resistance testing in adults infected with human immunodeficiency virus type 1: Recommendations of an International AIDS Society–USA Panel. CID. 2003;37:113-28.

  2. Ceccherini-Silberstein F, Svicher V, Sing T, Artese A, Santoro M, Forbici F, et al. Characterization and structural analysis of novel mutations in human immunodeficiency virus type 1 reverse transcriptase involved in the regulation of resistance to nonnucleoside inhibitors. J Virol. 2007;81(20):11507-19.

  3. Gorry C. Cuba’s National HIV/AIDS Program. MEDICC Review 2011;13(4):5-8.

  4. República de Cuba. Ministerio de Salud Pública. Plan estratégico nacional para la prevención y el control de las ITS y el VIH/Sida 2014-2018. [citado 24 mar 2014]. Disponible en: http://www.sld.cu/servicios/sida/

  5. Díaz HM. Infección y enfermedad por retrovirus humanos. Manual de Prácticas Médicas del Hospital Hermanos Ameijeiras. 2a ed. La Habana: Hospital “Hermanos Ameijeiras”; 2008. [citado 26 oct 2013]. Disponible en: http://www.hospitalameijeiras.sld.cu/hha/mpm/

  6. Domingo E, Mas A, Menéndez AL. Variabilidad genética del VIH-1. En: Vázquez S, González Lahoz J. Manual del SIDA. 3a ed. Madrid: IDEPSA; 1999. p. 41-58.

  7. Sens S, Tripathy SP, Paranjape RS. Antiretroviral drug resistance testing. J Postgrad Med. 2006;52:187-93.

  8. Aragonés C, Sánchez L, Campos JR, Pérez J. antiretroviral therapy adherence in persons with HIV/AIDS in Cuba. MEDICC Review. 2011;13(2):17-22.

  9. Aragonés C, Campos JR, Pérez D, Martínez A, Pérez J. SIDATRAT: Informatics to improve HIV/AIDS care. MEDICC Review. 2012;14(4):5-9.

  10. Machado LY, Dubed M, Díaz HM, Ruiz N, Romay D, Valdés N, et al. Transmitted HIV type 1 drug resistance in newly diagnosed Cuban patients. AIDS Res Hum Retroviruses. 2013;29(2):411-4.

  11. Bennett D, Myatt M, Bertagnolio S, Sutherland D, Gilks C. Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment. Antiviral Therapy. 2008;13(Supl.2):25-36.

  12. Rolo F, Miranda L, Wainberg M, Gu Z, Lobaina L, Noa E, et al. Envelope V3 region sequences of Cuban HIV-1 isolates. J Acquir Immune Defic Syndr. 1995;9:123-5.

  13. Blanco M, Rolo F, Martínez N, Gessa A, Díaz HM, Lubian AL. Aplicación del ensayo de Movilidad del Heteroduplex en los estudios de epidemiología molecular del VIH-1 en Cuba. Biotecnología Aplicada. 2001;18:149-53.

  14. Cuevas MT, Ruibal I, Villahermosa ML, Díaz H, Delgado E, Parga EV, et al. High HIV-1 genetic diversity in Cuba. AIDS. 2002;16:1643-53.

  15. Pérez L, Thomson M, Aragonés C, González Z, Pérez J, Casado G, et al. HIV type 1 molecular epidemiology in Cuba: high genetic diversity, frequent mosaicism, and recent expansion of BG intersubtype recombinant forms. AIDS Res Hum Retroviruses. 2006;22(8):724-33.

  16. Machado LY, Blanco M, Dubed M, Díaz HM, Ruiz NM, Valdés N, et al. HIV type 1 genetic diversity in newly diagnosed Cuban patients. AIDS Res Hum Retroviruses. 2012;28(8):956-60.

  17. Kourí V, Alemán Y, Pérez L, Pérez J, Fonseca C, Correa C, et al. High frequency of antiviral drug resistance and non-B subtypes in HIV-1 patients failing antiviral therapy in Cuba. J Clin Virology. 2012;55:348-55.

  18. Pérez L, Pérez Álvarez L, Carmona R, Aragonés C, Delgado E, Thomson M, et al. Genotypic resistence to antiretroviral drug in patients infected with several HIV type I genetic forms in Cuba. AIDS Res Hum Retroviruses. 2007;23(3):407-14.

  19. Pillay DGH, Matthias R, Dunn D, Phillips A, Sabin C, Evans B. UK Collaborative Group on HIV Drug Resistance. Estimating HIV-1 drug resistance in antiretroviraltreated individuals in the United Kingdom. J Infect Dis. 2005;192(6):967-73.

  20. Costagliola D, Descamps D, Assoumou L, Morand-Joubert L, Marcelin AG, Brodard V, et al. Prevalence of HIV-1 drug resistance in treated patients: a French nationwide study. J Acquir Immune Defic Syndr. 2007;46(1):12-8.

  21. de Mendoza C, Garrido C, Corral A, Ramirez-Olivencia G, Jimenez-Nacher I, Zahonero N, et al. Changing rates and patterns of drug resistance mutations in antiretroviral-experienced HIV-infected patients. AIDS Res Hum Retroviruses. 2007;23(7):879-85.

  22. Ruibal I, Cuevas MT, Díaz HM, Villahermosa ML, Noa E, Parga EV, et al. Genotypic resistance mutations to antiretroviral drugs in HIV-1 B and non-B subtypes from Cuba. Rev Panam Salud Pública. 2001;10(3):174-80.

  23. Little S, Frost S, Wong JK, Smith SM, Kosakovsky Pond S, Ignacio C, et al. Persistence of transmitted drug resistance among subjects with primary human immunodeficiency virus infection. J Virology. 2008;82(11):5510-18.

  24. Bangsberg DR, Moss AR, Deeks SG. Paradoxes of adherence and drugs resistance to HIV antiretroviral therapy. J Antimicrob Chemother. 2004;53(5) 696-9.




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