AEGiS-14IAC: Low prevalence of HIV resistance mutations in Sao Paulo, Brazil: some polimorphism present before the introduction of antiretroviral therapy.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Low prevalence of HIV resistance mutations in Sao Paulo, Brazil: some polimorphism present before the introduction of antiretroviral therapy.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. C10731)

Rodrigues R, Custodio RM, Leandro JP, Oliveira CA, Brigido LF
Adolfo Lutz Institute, Sao Paulo, Brazil

INTRODUCTION: Brazilian government guarantees free access to AIDS therapy,

INTRODUCTION: Brazilian government guarantees free access to AIDS therapy, and today over 100,000 patients, 40% in the state of Sao Paulo, are in antiretroviral therapy (ART). This might favor the emergence of resistance, as primary resistance seems to be a problem in different countries were ART is available. Monitoring is an important public health issue.

METHODS: Samples from 29 ART naïve volunteers, 13 with recent infection (seroconversion <1 year) were analyzed. DNA from cell pellets collected from 1995 to 2001 were amplified at reverse transcriptase (RT) and protease (PR) genes with nested PCR, followed by dye terminator and resolved in an ABI 377 sequencer.

RESULTS: No principal mutation to protease inhibitor (IP) was detected in this small sampling. Some polymorphism at RT were common, as at R211, present in 39%. Polymorphism at residues V106 and M184 was observed in one case each. Some mutations, as M36I were present in recent infections occuring before the availability of IP, and its prevalence did not increase thereafter. Although present in B subtype, they are significantly associated with HIV-1 F (p<0.003, fisher exact test), the second most prevalence clade, about 80% HIV-1 B and 20% F). One HIV-1 C RT was present in an infectious documented in mid-2000, and 2 B/D. B/F recombinations were present in one third of samples.

CONCLUSIONS: Rare principal mutations at RT, none at PR and some secondary polymorphism were observed in this small sampling supporting the assumption that prevalence of primary resistance is low and that genotyping is should not be currently indicated before introduction of therapy in the area.

Keywords: AEGIS, Prevalence, HIV Infections, HIV-1, HIV-1 Reverse Transcriptase, Antiretroviral Therapy, Highly Active, Mutation, HIV Seropositivity, Genotype, RNA-Directed DNA Polymerase, Drug Therapy, Combination, Polymorphism (Genetics), Polymerase Chain Reaction, Brazil, Human, therapy, epidemiology, genetics, drug therapy

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C10731