Pretreatment human immunodeficiency virus type 1 drug resistance in cuban patients during the period 2009-2017
Keywords:
HIV-1, resistance, subtypes, antiretroviral treatment, CubaAbstract
Introduction. The World Health Organization (WHO) recommends conducting nationally representative studies to estimate the prevalence of HIV pretreatment resistance to antiretrovirals (PDRs) to assess the effectiveness of first-line therapies. The objective of the present study was to determine the prevalence of PDR in Cuban adults infected with HIV-1. Methods. HIV resistance to antiretrovirals was determined in 610 Cuban patients in two time periods (469 patients between 2009-2016 and 141 patients during the national survey of HIV-1 PDR conducted during 2017, according to the recommendations issued by the WHO). Results and Discussion. In the period 2009-2016, 19% of the patients presented viruses with some mutation associated with the PDR of HIV-1 to antiretrovirals (10,4 % to some nucleoside reverse transcriptase inhibitor (NRTI), 12,8 % to some non nucleoside reverse transcriptase inhibitor (NNRTI), 2,8 % to some protease inhibitor (PI). In 2017, the prevalence of PDR was 29,8 % (95 %, CI 22,3-38.1). The prevalence was 10,6 % (95 %, IC 6,07-16,9) for some NRTI, 23,4 % (95 %, CI 16,7-31,3) for some NNRTI, and 1,4 % (95 %, CI 0,17-5,03) for some PI. It was concluded that 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.
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