Brazilian Network for HIV Drug Resistance Surveillance: a survey of individuals recently diagnosed with HIV

• Published in: Journal of the International AIDS Society Vol. 12; no. 1; p. 20
• Main Authors: Inocencio, Lilian A, Pereira, Anderson A, Sucupira, Maria Cecilia A, Fernandez, José Carlos C, Jorge, Célia P, Souza, Denise FC, Fink, Helena T, Diaz, Ricardo S, Becker, Irina M, Suffert, Theodoro A, Arruda, Monica B, Macedo, Olinda, Simão, Mariangela BG, Tanuri, Amilcar
• Format: Journal Article
• Language: English
• Published: Switzerland The International AIDS Society 18-09-2009; John Wiley & Sons, Inc; BioMed Central Ltd
• Subjects: Acquired immune deficiency syndrome; Age; AIDS; Antiviral agents; Caregivers; Children & youth; Complications and side effects; Decision making; Disclosure; Disease transmission; Distribution; Drug resistance; Drug therapy; Genetic screening; HIV; HIV patients; Human immunodeficiency virus; Methods; Mutation; non-nucleoside reverse transcriptase inhibitors; nucleoside reverse transcriptase inhibitors; Parents & parenting; Participation; Proteinase inhibitors; Risk factors; Sampling; Short Report; Statistics; Studies; Surveys; Young adults; Brazil; United States > US
• ISSN: 1758-2652; 1758-2652
• DOI: 10.1186/1758-2652-12-20

Use of antiretrovirals is widespread in Brazil, where more than 200,000 individuals are under treatment. Although general prevalence of primary antiretroviral resistance in Brazil is low, systematic sampling in large metropolitan areas has not being performed.
The HIV Threshold Survey methodology (HIV‐THS, WHO) was utilized, targeting Brazil's four major regions and selecting the six most populated state capitals: Sao Paulo, Rio de Janeiro, Salvador, Porto Alegre, Brasilia and Belem. We were able to sequence samples from 210 individuals with recent HIV diagnosis, 17 of them (8.1%) carrying HIV isolates with primary antiretroviral resistance mutations. Five, nine and four isolates showed mutations related to resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non‐nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs), respectively. Using HIV‐THS, we could find an intermediate level of transmitted resistance (5% to 15%) in Belem/Brasilia, Sao Paulo and Rio de Janeiro. Lower level of transmitted resistance (<5%) were observed in the other areas. Despite the extensive antiretroviral exposure and high rates of virologic antiretroviral failure in Brazil, the general prevalence of primary resistance is still low. However, an intermediate level of primary resistance was found in the four major Brazilian cities, confirming the critical need to start larger sampling surveys to better define the risk factors associated with transmission of resistant HIV.