title: Moderate prevalence of transmitted drug resistance mutations among antiretroviral-naive HIV-infected pregnant women in Rio de Janeiro, Brazil.
abstract: Transmission of drug-resistant HIV-1 strains has been gaining attention and is becoming a growing problem throughout the world. The aim of this study was to determine the prevalence of transmitted drug resistance mutations (TDRM) among antiretroviral (ARV)-naive HIV-infected pregnant women in Rio de Janeiro, Brazil. ARV-naive pregnant women were recruited at Hospital Geral de Nova Iguacu (HGNI), Rio de Janeiro, from 2005 to 2008. HIV genotyping was carried out using ViroSeq (Abbott v. 2.0). TDRM were detected using the Calibrated Population Resistance Tool-CPR v. 6.0.The prevalence of mutations associated with resistance in the protease and reverse transcriptase regions of the HIV genome were assessed in samples collected prior to initiation of ARV prophylaxis or treatment. Among 238 eligible specimens that were collected, 197 samples were successfully amplified using reverse transcription polymerase chain reaction. Eighty-one percent of women were infected with HIV subtype B, 10% with subtype F1 viruses, 1.0% with subtype C virus, and 8.0% with recombinant forms of the virus. The prevalence of HIV TDRM was 5.6% for nucleoside reverse transcriptase inhibitors, 2.0% for nonnucleoside reverse transcriptase inhibitors, and 3.0% for protease inhibitors. The overall prevalence of any drug resistance was 10.7%. There were no multiclass resistant strains identified in the analyzed samples. The prevalence of HIV TDRM among the pregnant women in our cohort was moderate. Resistance testing should be encouraged in Rio de Janeiro, among other locations, for all HIV-infected pregnant women prior to prevention of mother-to-child transmission of HIV.
authors.affiliation: Instituto Oswaldo Cruz/FIOCRUZ, AIDS and Molecular Immunology Laboratory, Rio de Janeiro, Brazil.
authors.forename: José H
authors.initials: JH
authors.lastname: Pilotto
authors.forename: Beatriz
authors.initials: B
authors.lastname: Grinsztejn
authors.forename: Valdilea G
authors.initials: VG
authors.lastname: Veloso
authors.forename: Luciane S
authors.initials: LS
authors.lastname: Velasque
authors.forename: Ruth K
authors.initials: RK
authors.lastname: Friedman
authors.forename: Ronaldo I
authors.initials: RI
authors.lastname: Moreira
authors.forename: Adriana
authors.initials: A
authors.lastname: Rodrigues-Pedro
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Oliveira
authors.forename: Judith S
authors.initials: JS
authors.lastname: Currier
authors.forename: Mariza G
authors.initials: MG
authors.lastname: Morgado
mesh_terms: D000328:Adult; D001938:Brazil; D015331:Cohort Studies; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D016679:Genome, Viral; D015658:HIV Infections / Q000150:complications* / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D009154:Mutation; D059645:Mutation Rate; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011446:Prospective Studies; D055815:Young Adult