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High Level of Pretreatment and Acquired Human Immunodeficiency Virus Drug Resistance in El Salvador: A Nationally Representative Survey, 2018-2019.
Girón-Callejas, Amalia; García-Morales, Claudia; Mendizabal-Burastero, Ricardo; Quezada, Alma; Ruiz, Lisette; Arguera, Nelly; Sorto, Salvador; Nieto, Ana I; Tapia-Trejo, Daniela; López-Sánchez, Dulce M; Pérez-García, Marissa; Cruz, Luis; Andino, Raúl; Sajquim, Edgar; Juárez, Sandra I; Farach, Nasim; Ravasi, Giovanni; Northbrook, Sanny; Reyes-Terán, Gustavo; Ávila-Ríos, Santiago.
Afiliación
  • Girón-Callejas A; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
  • García-Morales C; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico.
  • Mendizabal-Burastero R; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
  • Quezada A; Ministerio de Salud de El Salvador, San Salvador, El Salvador.
  • Ruiz L; Ministerio de Salud de El Salvador, San Salvador, El Salvador.
  • Arguera N; Ministerio de Salud de El Salvador, San Salvador, El Salvador.
  • Sorto S; Ministerio de Salud de El Salvador, San Salvador, El Salvador.
  • Nieto AI; Ministerio de Salud de El Salvador, San Salvador, El Salvador.
  • Tapia-Trejo D; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico.
  • López-Sánchez DM; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico.
  • Pérez-García M; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico.
  • Cruz L; Centro de Estudios en Salud, Universidad del Valle de Guatemala, San Salvador, El Salvador.
  • Andino R; Centro de Estudios en Salud, Universidad del Valle de Guatemala, San Salvador, El Salvador.
  • Sajquim E; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
  • Juárez SI; US Centers for Disease Control and Prevention, Central American Region, Guatemala City, Guatemala.
  • Farach N; US Centers for Disease Control and Prevention, Central American Region, Guatemala City, Guatemala.
  • Ravasi G; Pan-American Health Organization, Washington, District of Columbia, USA.
  • Northbrook S; US Centers for Disease Control and Prevention, Central American Region, Guatemala City, Guatemala.
  • Reyes-Terán G; Coordinating Commission of the Mexican National Institutes of Health, Mexico City, Mexico.
  • Ávila-Ríos S; Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico.
Open Forum Infect Dis ; 9(11): ofac580, 2022 Nov.
Article en En | MEDLINE | ID: mdl-36438615
Background: Human immunodeficiency virus drug resistance (HIVDR) can negatively impact the effectiveness of antiretroviral therapy (ART). We aimed to estimate the prevalence of pretreatment HIVDR (PDR) among ART initiators and the prevalence of viral load (VL) suppression and acquired HIVDR among individuals receiving ART for 12 ± 3 months (ADR12) and ≥48 months (ADR48) in El Salvador. Methods: Nationally representative cross-sectional PDR, ADR12 and ADR48 surveys were conducted among adults with HIV from October 2018 to August 2019, following World Health Organization-recommended methods. Demographic and clinic data and blood specimens were collected. Results: Two hundred sixty participants were enrolled in the PDR survey, 230 in ADR12 and 425 in ADR48. Twenty-seven percent (95% confidence interval [CI], 17.1%-39.9%) of ART initiators had PDR to efavirenz or nevirapine. The prevalence of VL suppression was 88.8% (95% CI, 83.1%-92.8%) in ADR12 and 80.5% (95% CI, 76.6%-84.0%) in ADR48 surveys. Among people with HIV receiving a first-line nonnucleoside reverse transcriptase inhibitor (NNRTI)-based ART regimens and with unsuppressed VL, the prevalence of ADR to efavirenz or nevirapine was 72.0% (95% CI, 32.3%-93.3%) and 95.0% (68.5%-99.4%) in the ADR12 and ADR28 surveys, respectively. ADR12 to boosted protease inhibitors (PI/r) or integrase strand transfer inhibitors (INSTIs) was not observed. ADR48 was 1.3% (95% CI, 0.2%-9.6%) and 2.1% (0.3%-13.7%), respectively. Conclusions: Programmatic improvements in ART delivery are urgently needed in El Salvador to address the high levels of resistance to efavirenz or nevirapine among ART initiators and the low VL suppression prevalence among individuals on treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies País/Región como asunto: America central / El salvador Idioma: En Revista: Open Forum Infect Dis Año: 2022 Tipo del documento: Article País de afiliación: Guatemala Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies País/Región como asunto: America central / El salvador Idioma: En Revista: Open Forum Infect Dis Año: 2022 Tipo del documento: Article País de afiliación: Guatemala Pais de publicación: Estados Unidos