Brazilian Network for HIV Drug Resistance Surveillance: a survey of individuals recently diagnosed with HIV.
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.
Inocencio
Lilian A
LA
Lab Virologia Molecular, IB-UFRJ, Rio de Janeiro, RJ, Brazil. atanuri@biologia.ufrj.br.
Pereira
Anderson A
AA
Sucupira
Maria Cecilia A
MC
Fernandez
José Carlos C
JC
Jorge
Célia P
CP
Souza
Denise Fc
DF
Fink
Helena T
HT
Diaz
Ricardo S
RS
Becker
Irina M
IM
Suffert
Theodoro A
TA
Arruda
Monica B
MB
Macedo
Olinda
O
Simão
Mariangela Bg
MB
Tanuri
Amilcar
A