2 research outputs found
Antiretroviral resistance in individuals presenting therapeutic failure and subtypes of the human immunodeficiency virus type 1 in the Northeast Region of Brazil
This study aimed to analyze human immunodeficiency virus (HIV) mutation
profiles related to antiretroviral resistance following therapeutic
failure, and the distribution of hiv subtypes in the Northeast Region
of Brazil. A total of 576 blood samples from AIDS patients presenting
therapeutic failure between 2002 and 2004 were analyzed. The genotyping
kit viroSeq® was used to perform viral amplification in order to
identify mutations related to hiv pol gene resistance. An index of
91.1% of the patients presented mutations for nucleoside reverse
transcriptase inhibitors (nrti), 58.7% for non-nucleoside reverse
transcriptase inhibitors (nnrti), and 94.8% for protease inhibitors
(pi). The most prevalent mutations were 184V and 215E for nrti, 103N
and 190A for nnrti. Most mutations associated with PIs were secondary,
but significant frequencies were observed in codons 90 (25.2%), 82
(21.1%), and 30 (16.2%). The resistance index to one class of
antiretrovirals was 14%, to two classes of antiretrovirals 61%, and to
three classes 18.9%. Subtype B was the most prevalent (82.4%) followed
by subtype F (11.8%). The prevalence of mutations related to nrti and
nnrti was the same in the two subtypes, but codon analysis related to
PI showed a higher frequency of mutations in codon 63 in subtype B and
in codon 36 in subtype F. The present study showed that there was a
high frequency of primary mutations, which offered resistance to nrti
and nnrti. Monitoring patients with treatment failure is an important
tool for aiding physicians in rescue therapy