Prevalência de resistência transmitida do HIV-1 aos antirretrovirais no Brasil, pré- início de tratamento

• Ano de defesa: 2011
• Autor(a) principal: Soares, Celina Maria Pereira de Moraes [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Chronic patients pre-therapy; Molecular epidemiology; Pacientes crônicos pré-terapia; Resistência transmitida; HIV-1; Drug Resistance, Viral; Anti-HIV Agents/pharmacology; Antiretroviral Therapy, Highly Active; HIV-1/drug effects; Humans; Epidemiologia molecular; Transmitted resistance; Farmacorresistência Viral; Fármacos Anti-HIV/farmacologia; Terapia Antirretroviral de Alta Atividade; HIV-1/efeitos de drogas; Humanos
• Link de acesso: http://repositorio.unifesp.br/handle/11600/9962

The selection of resistance mutations to antiretroviral drugs after failure of antiretroviral therapy represents a major challenge for decision-making of new therapeutic regimens in the global pandemic. The high genetic variability of HIV- 1and the selection of resistance mutations trasmitted to patients chronically infected without having participated in the regimen has been the subject of several studies in the world. Resistance patterns are studied mainly in European countries and the United States, wich have majority prevalence of subtype B. However, studies that guide the selection of transmitted mutants to antiretroviral drugs and non-B subtypes, and in their recombinant forms, has increased significantly in the several regions of the world. In Brazil, these studies are conducted sporadically and in different regions of the country and specially in newly infected patients. The high genetic variability of HIV-1 is represented in our country so diverse, with the presence of subtype B, followed by F, and specifically in the South region, the prevalence of subtype C. In addition, coexist the prevalence of recombinant forms, where the principal is the subtype BF, followed by BC. The main objective of this study estimate the characteristics of transmitted resistance mutations to antiretroviral drugs in HIV-1 ol gene, fractions of reverse transcriptase and protease, with mutational analysis of the profile by a population patients chronically infected with HIV-1 and not treated, but with indication of immediate initiation of treatment. We evaluated the patients represented in the demographic regions of Brazil. The national prevalence resulted in 12.1% of transmitted resistance mutations to antiretroviral (intermediate grade 5% to 15%) and 70.8%, 15.5% C, 6.4% F, 4.0% BF and 3.0% BC in the classification of subtypes of HIV-1. In addition, the prevalence of transmitted mutations, the subtypes of HIV-1 and sociodemographic characteristics, laboratory parameters and behavior data in population HIV-1 positive pre-treatment were classified by the cities in five Brazilian regions.