Análise do perfil de resistência do vírus da imunodeficiência humana tipo 1 (HIV-1) aos inibidores da transcriptase reversa não análogos de nucleosídeos (ITRNN) em Goiás
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2010-07-20
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Universidade Federal de Goiás
Resumo
Objectives: To describe and analyze HIV-1 resistance mutational profiles associated with non-
nucleoside reverse transcriptase inhibitors (NNRTIs) from patients experiencing antiretroviral
therapy failure; at the main reference public Center in Goiás State. Methods: Samples from 474
patients were collected and processed according to the National Genotyping Network
(RENAGENO), between 2006 and e 2009. Patient’s files (genotype exams) and medical records
were used as data source. Number of TCD4 cells, HIV-1 viral load quantification, viral subtype
and mutation profile assessment (TRUGENE HIV-1 Genotyping Test e ViroSeq System) were
done according to the routine adopted by Central State Laboratory (LACEN). Resistance mutation
profiles were identified using the Brazilian Algorithm and the Stanford Database Program. Cross
resistance between NNRTIs: nevirapine, efavirenz and etravirine were analyzed. Descriptive and
exploratory analyses were performed for socio-demographics variables and laboratory results
(SPSS 15.0). Results: Samples from 126 adult patients were resistant to nevirapine (NVP) and
efavirenz (EVF) Subtyping analysis showed a predominance of subtype B (86.1%), followed by
BF1 recombinant (7.8%). Half of the patients received three or more antiretroviral therapy regimes.
The most frequent mutations were 103N (72.2%) and 225H (22.2%). Mutations related to
decreased etravirine (ETV) activity were detected in 8 codons: 98, 100, 101, 181, 188, 190 e 230
Intermediate ETV resistance were present in 27.0% and 15.1% of the samples, according to the
Brazilian protocol and to Stanford Db Program, respectively. High-degree of ETV resistance were
present in 10 samples (7.9%; IC95% 3.9-14.1), according to the Brazilian protocol Using the
Stanford dB Program, 3 out of 126 patients (2.4%; IC95% 3.9-14.1) had high-degree of resistance.
Clinical characteristics, number of T CD4 cells and viral load were not predictors to ETV resistance.
Conclusions: The presence of at least one mutation potentially associated with decreased
virological response to ETV was frequent, in a population highly exposed to NNRTIs. Otherwise
high-degree of cross resistance to ETV was not common, suggesting that this drug could be helpful
for patients failing to first generation NNRTIs.
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PACHECO, Priscila Ribeiro Guimarães. Análise do perfil de resistência do vírus da imunodeficiência humana tipo 1 (HIV-1) aos inibidores da transcriptase reversa não análogos de nucleosídeos (ITRNN) em Goiás. 2010. 103 f.
Dissertação (Mestrado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2010.