Update on primary HIV-1 resistance in Argentina: emergence of mutations conferring high-level resistance to nonnucleoside reverse transcriptase inhibitors in drug-naive patients

J Acquir Immune Defic Syndr. 2006 Aug 1;42(4):506-10. doi: 10.1097/01.qai.0000222285.44460.e2.

Abstract

Here we present a survey including 52 drug-naive recently HIV-1-infected subjects from Buenos Aires City and province (79%) and 3 other regions in Argentina (21%). Recent infections were established from previous negative serology (32/52), indeterminate Western blot (12/52), or acute retroviral syndrome after high-risk HIV exposure (8/52) within 9 months before genotyping (median time, 4.2 months). Genotyping was performed from plasma by sequencing both protease and reverse transcriptase. Phylogenetic analysis combined with bootscanning resulted in 21 subtype B sequences and 31 B/F recombinants (RecBF). On protease, minor resistance-related mutations were found in both subtype B and RecBF with low frequencies. The substitution L89M, recently suggested as a resistance-related mutation in some subtype F viruses, was observed in 1 RecBF. On reverse transcriptase, major resistance-related mutations were found in 4 of 52 (7.7%) patients from different health centers: M41L (subtype B) and K103N+/-P225H (1 RecBF and 2 subtype B). The greater than 5% resistance threshold found indicates a need for sentinel resistance surveillances calling for an update in the current resistance testing guidelines in Argentina.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Argentina
  • Base Sequence
  • DNA Primers
  • Female
  • HIV Infections / drug therapy*
  • HIV-1
  • Humans
  • Male
  • Mutation*
  • Phylogeny
  • Polymorphism, Genetic
  • Recombination, Genetic
  • Reverse Transcriptase Inhibitors / therapeutic use*
  • Reverse Transcriptase Polymerase Chain Reaction

Substances

  • DNA Primers
  • Reverse Transcriptase Inhibitors