INBIRS 24491
INSTITUTO DE INVESTIGACIONES BIOMEDICAS EN RETROVIRUS Y SIDA
Unidad Ejecutora - UE
artículos
Título:
Prevalence of rilpivirine resistance in people starting antiretroviral treatment in Argentina
Autor/es:
BARBÁS, MARIA G; SALOMÓN, HORACIO; FALISTOCCO, CARLOS; KADEMIÁN, SILVIA; CUDOLÁ, ANALIA; BISSIO, EMILIANO; BOUZAS, MARIA B; FERNÁNDEZ GIULIANO, SILVINA
Revista:
ANTIVIRAL THERAPY.
Editorial:
INT MEDICAL PRESS LTD
Referencias:
Año: 2017
ISSN:
1359-6535
Resumen:
Rilpivirine-based regimens are now preferred or alternative first-line regimens according to many HIV treatment guidelines. Recently, a surveillance study conducted in our country determined that prevalence of pretreatment resistance to first-generation NNRTIs was 10%. The aim of this study was to analyze the prevalence of resistance mutations to newer generation NNRTIs in the population starting ART in Argentina.METHODS:We analyzed the prevalence of resistance mutations to rilpivirine and etravirine (according to the IAS list), obtained through a nationally representative pretreatment HIV-drug resistance (PDR) surveillance study performed in Argentina in 2014-2015. Briefly, 25 ART-dispensing sites throughout the country were randomly chosen to enroll 330 adults starting ART. Samples were processed with Trugene (Siemens)®, and analyzed using the Stanford algorithm.RESULTS:All 270 samples corresponding to participants with no prior exposure to antiretroviral drugs were included in this analysis. Median (IQR) age was 35 years (28-43); 66.7% were male; median(IQR) CD4 count was 284/mm3(112-489). The prevalence of resistance to any antiretroviral was 16% (±5%), and prevalence of NNRTI RAMs was 13% (±4%). The prevalence of resistance to rilpivirine was 8% (±3%). Prevalence of resistance to etravirine was 4% (±3%). The most frequent mutations conferring resistance to rilpivirine were: E138A (n=6) and G190A (n=4).CONCLUSIONS:This PDR surveillance study showed concerning levels of HIVDR in Argentina, not only for first-generation NNRTIs but also to rilpivirine. In our setting, performing resistance testing would be necessary before prescription of ART even if a second-generation NNRTI based regimen were used as first-line therapy.
