title: [Patterns of HIV-1 resistance to antiretroviral drugs in patients with virologic failure: Roosevelt Hospital, Guatemala 2008-2012].
abstract: OBJECTIVE
  To assess the secondary resistance patterns of HIV-1to Anti-Retroviral Agents drugs (ART) in patients with virological failure in the main HIV care center in Guatemala.
  
  
  METHODS
  Using the Stanford HIV Database,HIV pol sequences were analyzed to obtain resistance patterns in patients with first-failure to ART or multiple-failures (2 or more regimens failed), from 2008 to 2012. Proportions and odds ratio (OR) with 95% confidence intervals (95%CI) were calculated.
  
  
  RESULTS
  83% (43) in the first-failure and 75% (30) in multiple-failures had resistance. The highest frequency (70%)of resistance was found in the non-nucleoside-inhibitors ART family. 44% (42) showed resistance to two ART families and 4% (4) to the three families. First-failure patients had higher risk of nucleoside-inhibitor resistance (OR:3.0, 95%CI 1.29-6.98) and multidrug resistance (OR:4.94, 95%CI 1.98-12.32). Most frequent mutations were: M184V, K103N and K65R (71, 50 and 22%, respectively). 70% of patients with first-failure were resistant to at least one of the drugs used as second ART in Guatemala (ABC, ddI or AZT).
  
  
  CONCLUSIONS
  The high level of HIV-1 resistance to ART observed, suggest the need to amend the current second line regimen treatments in Guatemala and the importance of viral genotyping in all patients with first-failure to ART.
authors: Ricardo
authors: R
authors: Mendizábal-Burastero
authors: Amalia C
authors: AC
authors: Girón-Callejas
authors: Jorge A
authors: JA
authors: Rodas-Cruz
authors: Rodolfo
authors: R
authors: Pinzón
authors: M Lisbeth
authors: ML
authors: Romero
authors: E Marisol
authors: EM
authors: Boror
authors: Carlos R
authors: CR
authors: Mejía-Villatoro
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D006166:Guatemala; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D009154:Mutation / Q000235:genetics*; D012189:Retrospective Studies; D017211:Treatment Failure; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents