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Trends in Prevalence of HIV-1 Drug Resistance in a Public Clinic in Maputo, Mozambique
Bila, Dulce Celina Adolfo; Boullosa, Lídia Teodoro; Vubil, Adolfo Salvador; Mabunda, Nédio Jonas; Abreu, Celina Monteiro; Ismael, Nalia; Jani, Ilesh Vinodrai; Tanuri, Amilcar.
Afiliación
  • Bila, Dulce Celina Adolfo; instituto nacional de saude. Universidade Federal do Rio de janeiro. Rio de janeiro. BR
  • Boullosa, Lídia Teodoro; Universidade Federal do Rio de janeiro. Universidade Eduardo Mondlane. Rio de janeiro. BR
  • Vubil, Adolfo Salvador; instituto nacional de saude. Maputo. MZ
  • Mabunda, Nédio Jonas; instituto nacional de saúde. Maputo. MZ
  • Abreu, Celina Monteiro; Universidade Federal do Rio de janeiro. Rio de janeiro. BR
  • Ismael, Nalia; instituto nacional de saude. Maputo. MZ
  • Jani, Ilesh Vinodrai; instituto nacional de saude. Maputo. MZ
  • Tanuri, Amilcar; Universidade Federal do Rio de janeiro. Rio de janeiro. BR
PLos ONE ; 7(9): 1-12, Sept 11. 2012. tab., graf
Article en En | RSDM | ID: biblio-1519596
Biblioteca responsable: MZ1.1
ABSTRACT
Background Anobservational study was conducted in Maputo, Mozambique, to investigate trends in prevalence of HIV drug resistance (HIVDR) in antiretroviral (ART) naïve subjects initiating highly active antiretroviral treatment (HAART). Methodology/Principal Findings Toevaluate the pattern of drug resistance mutations (DRMs) found in adults on ART failing first-line HAART [patients with detectable viral load (VL)]. Untreated subjects [Group 1 (G1; n=99)] and 274 treated subjects with variable length of exposure to ARV´s [6­12 months, Group 2(G2;n=93); 12-24 months, Group 3(G3;n=81); >24 months (G4;n=100)] were enrolled. Virological and immunological failure (VF and IF) were measured based on viral load (VL) and Tlymphocyte CD4+cells (TCD4+) count and genotypic resistance was also performed. Major subtype found was C (untreated n=66, 97,06%; treated n=36, 91.7%). Maximumvirological suppression was observed in G3, and significant differences intragroup were observed between VF and IF in G4 (p=0.022). Intergroup differences were observed between G3andG4forVF(p=0.023) andIFbetweenG2andG4(p=0.0018). Viral suppression (5000 copies/ml) identified 50% of subjects carrying DRM compared to 100% when lower VLcut-off was used (<50 copies/ml). Length of exposure to ARVs was directly proportional to the complexity of DRM patterns. In Mozambique, VL suppression was achieved in 76% of individuals after 24 months on HAART. This is in agreement with WHO target for HIVDR prevention target (70%). Conclusions Wedemonstratedthat the best way to determine therapeutic failure is VL compared to CD4 counts. The rationalized use of VL testing is needed to ensure timely detection of treatment failures preventing the occurrence of TDR and new infections.
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Texto completo: 1 Colección: 06-national / MZ Base de datos: RSDM Asunto principal: Factores R / VIH / Antirretrovirales / Mozambique Límite: Adult / Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: PLos ONE Año: 2012 Tipo del documento: Article
Texto completo
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Imprimir
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Texto completo: 1 Colección: 06-national / MZ Base de datos: RSDM Asunto principal: Factores R / VIH / Antirretrovirales / Mozambique Límite: Adult / Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: PLos ONE Año: 2012 Tipo del documento: Article