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Revista Panamericana de Salud Pública

Print version ISSN 1020-4989

Abstract

AVILA-RIOS, Santiago et al. Prevalence and patterns of HIV transmitted drug resistance in Guatemala. Rev Panam Salud Publica [online]. 2011, vol.30, n.6, pp. 641-648. ISSN 1020-4989.  http://dx.doi.org/10.1590/S1020-49892011001200024.

OBJECTIVE: To assess human immunodeficiency virus (HIV) diversity and the prevalence of transmitted drug resistance (TDR) in Guatemala. METHODS: One  hundred  forty-five  antiretroviral  treatment-naïve  patients  referred  to  the Roosevelt  Hospital  in  Guatemala  City  were  enrolled  from  October  2010  to  March  2011. Plasma HIV pol sequences were obtained and TDR was assessed with the Stanford algorithm and the World Health Organization (WHO) TDR surveillance mutation list. RESULTS: HIV subtype B was highly prevalent in Guatemala (96.6%, 140/145), and a 2.8% (4/145) prevalence of BF1 recombinants and 0.7% (1/145) prevalence of subtype C viruses were  found.  TDR  prevalence  for  the  study  period  was  8.3%  (12/145)  with  the  Stanford database algorithm (score > 15) and the WHO TDR surveillance mutation list. Most TDR cases were associated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) (83.3%, 10/12);  a  low  prevalence  of  nucleoside  reverse  transcriptase  inhibitors  and  protease  inhibitors was observed in the cohort (< 1% for both families). Low selection of antiretroviral drug resistance  mutations  was  found,  except  for  NNRTI-associated  mutations.  Major  NNRTI mutations such as K101E, K103N, and E138K showed higher frequencies than expected in ART-naïve populations. Higher literacy was associated with a greater risk of TDR (odds ratio 4.14, P = 0.0264). CONCLUSIONS: This study represents one of the first efforts to describe HIV diversity and TDR prevalence and trends in Guatemala. TDR prevalence in Guatemala was at the intermediate level. Most TDR cases were associated with NNRTIs. Further and continuous TDR surveillance is necessary to gain more indepth knowledge about TDR spread and trends in Guatemala and to optimize treatment outcomes in the country.

Keywords : HIV; drug  resistance,  viral; molecular  epidemiology; epidemiologic  surveillance; Guatemala.

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