[Primary antiretroviral drug resistance among patients diagnosed with HIV infection in Gran Canaria (Spain) between 2002 and 2005].
BACKGROUND
This study examines the prevalence of primary resistance to antiretroviral drugs in patients diagnosed with HIV infection during 2002 to 2005 and determines the clinical and epidemiological characteristics of this population.


METHODS
A prospective analysis of genotypic resistance was carried out in 125 patients by gene sequencing (88.0% diagnosed in 2002, 28.9% in 2003-2004, and 87.9% in 2005). Thirteen patients had a diagnosis of recent primary infection.


RESULTS
Sixteen patients (12.8%) carried viruses with at least one drug-resistance mutation; among them, 4 had recent infection (30.8%) and 12 chronic infection or infection of unknown duration (10.7%). Six patients (4.8%) presented at least one resistance mutation to nucleoside/tide reverse transcriptase inhibitors, 9 patients (7.2%) to non-nucleoside/ tide reverse transcriptase inhibitors inhibitors and 2 patients (1.6%) to protease inhibitors. One patient (0.8%) harbored a multidrug-resistant variant. The frequency of primary resistance was higher in patients with HIV subtype B (15.5%), in the homosexual/bisexual population (17.9%), and in patients diagnosed in 2005 (17.9%). Prevalence increased from 9.3% in 2002 to 16.3% in 2005 in chronically infected patients or those with unknown duration of the infection.


CONCLUSIONS
Primary resistance to antiretroviral drugs is high in both recent and chronic HIV infection and has increased in recent years. Genotype resistance testing in patients with a diagnosis of HIV infection is recommended before beginning antiretroviral therapy.
Sánchez Oñoro
Mónica
M
Servicio de Microbiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
López
María José Pena
MJ
Santana
Miguel Angel Cárdenes
MA
Andés
José María Zarzalejos
JM
Campelo
Fernando Artiles
FA
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001266:Atlantic Islands / Q000453:epidemiology; D024921:Drug Resistance, Multiple, Viral / Q000235:genetics; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D016333:HIV Protease / Q000235:genetics; D017320:HIV Protease Inhibitors / Q000494:pharmacology; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D020125:Mutation, Missense; D017354:Point Mutation; D011446:Prospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase; D016333:HIV Protease; C514803:p16 protease, Human immunodeficiency virus 1