1. National survey of pre-treatment HIV drug resistance in Cuban patients
- Author
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L. Martinez, José Joanes, María I. Lantero, Mireida Rodríguez, Laura S. López, Neisy Valdes, Caridad B. Rivero, María Teresa Pérez, Marta Dubed, Dania Romay, Héctor M. Díaz, Madeline Blanco, Liuber Y. Machado, Isis Cancio, and Enrique Noa
- Subjects
0301 basic medicine ,RNA viruses ,Male ,Cross-sectional study ,Epidemiology ,HIV Infections ,Drug resistance ,Pathology and Laboratory Medicine ,Geographical locations ,Database and Informatics Methods ,Immunodeficiency Viruses ,Antiretroviral Therapy, Highly Active ,Medicine and Health Sciences ,Prevalence ,Medicine ,Public and Occupational Health ,Young adult ,Phylogeny ,Multidisciplinary ,Antimicrobials ,Incidence (epidemiology) ,Cuba ,Drugs ,Antiretrovirals ,Middle Aged ,Antivirals ,Vaccination and Immunization ,Genes, pol ,Medical Microbiology ,HIV epidemiology ,Viral Pathogens ,Viruses ,Female ,Pathogens ,Viral load ,Sequence Analysis ,HIV drug resistance ,Research Article ,Adult ,medicine.medical_specialty ,Adolescent ,Bioinformatics ,Anti-HIV Agents ,Science ,030106 microbiology ,Immunology ,Antiretroviral Therapy ,Sequence Databases ,Research and Analysis Methods ,Microbiology ,03 medical and health sciences ,Young Adult ,Pharmacotherapy ,Antiviral Therapy ,Internal medicine ,Microbial Control ,Virology ,Retroviruses ,Drug Resistance, Viral ,Highly-Active Antiretroviral Therapy ,Humans ,Microbial Pathogens ,Aged ,Pharmacology ,Caribbean ,business.industry ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,030104 developmental biology ,Biological Databases ,Cross-Sectional Studies ,North America ,Mutation ,HIV-1 ,Antimicrobial Resistance ,Preventive Medicine ,People and places ,business - Abstract
Background The World Health Organization (WHO) recommends a method to estimate nationally representative pretreatment HIV drug resistance (PDR) in order to evaluate the effectiveness of first -line treatments. The objective of the present study was to determine the prevalence of PDR in Cuban adults infected with HIV-1. Materials and methods A cross-sectional study in Cuban adults infected with HIV-1 over 18 years was conducted. The probability proportional to size method for the selection of municipalities and patients without a prior history of antiretroviral treatment during the period from January 2017 to June 2017 was used. The plasma from 141 patients from 15 municipalities for the determination of viral subtype and HIV drug resistance was collected. Some clinical and epidemiological variables were evaluated. Results 80. 9% of the patients corresponded to the male sex and 76.3% were men who have sex with other men (MSM). The median CD4 count was 371 cells / mm3 and the median viral load was 68000 copies / mL. The predominant genetic variants were subtype B (26.9%), CRF19_cpx (24.1%), CRF 20, 23, 24_BG (23.4%) and CRF18_cpx (12%). Overall, the prevalence of PDR was 29.8% (95%, CI 22.3-38.1). The prevalence was 12.8% (95%, CI 6.07-16.9) for any nucleoside reverse transcriptase inhibitor (NRTI), 23.4% (95%, CI 16.7-31.3) for any non-reverse transcriptase inhibitor (NNRTI) and 1.4% (95%, CI 0.17-5.03) for any protease inhibitor (PI). The most frequent mutations detected were K103N (12.9%), G190A (6.4%) and Y181C (4.8%). Conclusions The NNRTI prevalence above 10% in our study indicates that the first-line antiretroviral therapy in Cuba may be less effective and supports the need to look for new treatment options that contribute to therapeutic success and help the country achieve the global goals 90-90-90 set forth by UNAIDS.
- Published
- 2019