TY - JOUR T1 - Transmitted drug resistance in patients with acute/recent HIV infection in Brazil JO - The Brazilian Journal of Infectious Diseases T2 - AU - Ferreira,Ana Cristina G. AU - Coelho,Lara E. AU - Grinsztejn,Eduarda AU - Jesus,Carlos S. de AU - Guimarães,Monick L. AU - Veloso,Valdiléa G. AU - Grinsztejn,Beatriz AU - Cardoso,Sandra W. SN - 14138670 M3 - 10.1016/j.bjid.2017.03.013 DO - 10.1016/j.bjid.2017.03.013 UR - https://www.bjid.org.br/en-transmitted-drug-resistance-in-patients-articulo-S1413867016303300 AB - IntroductionThe widespread use of antiretroviral therapy increased the transmission of antiretroviral resistant HIV strains. Antiretroviral therapy initiation during acute/recent HIV infection limits HIV reservoirs and improves immune response in HIV infected individuals. Transmitted drug resistance may jeopardize the early goals of early antiretroviral treatment among acute/recent HIV infected patients. MethodsPatients with acute/recent HIV infection who underwent resistance test before antiretroviral treatment initiation were included in this analysis. HIV-1 sequences were obtained using an in house protease/reverse transcriptase genotyping assay. Transmitted drug resistance was identified according to the Stanford HIV Database for Transmitted Drug Resistance Mutations, based on WHO 2009 surveillance list, and HIV-1 subtyping according to Rega HIV-1 subtyping tool. Comparison between patients with and without transmitted drug resistance was made using Kruskal–Wallis and Chi-square tests. ResultsForty-three patients were included, 13 with acute HIV infection and 30 with recent HIV infection. The overall transmitted drug resistance prevalence was 16.3% (95% confidence interval [CI]: 8.1–30.0%). The highest prevalence of resistance (11.6%, 95% CI: 8.1–24.5) was against non-nucleoside reverse transcriptase inhibitors, and K103N was the most frequently identified mutation. ConclusionsThe high prevalence of nonnucleoside reverse transcriptase inhibitors resistance indicates that efavirenz-based regimen without prior resistance testing is not ideal for acutely/recently HIV-infected individuals in our setting. In this context, the recent proposal of including integrase inhibitors as a first line regimen in Brazil could be an advantage for the treatment of newly HIV infected individuals. However, it also poses a new challenge, since integrase resistance test is not routinely performed for antiretroviral naive individuals. Further studies on transmitted drug resistance among acutely/recently HIV-infected are needed to inform the predictors of transmitted resistance and the antiretroviral therapy outcomes among these population. ER -