Increased Rate of Protease Inhibitor-resistance Associated Mutations in Human Immunodeficiency Viruses Infecting Mexicans who Had Been Living Abroad

Abstract

Background: Migrants face multiple barriers to accessing health services and antiretroviral therapy (ART). We tested the hypothesis that HIV-infected ART-experienced Mexicans with a history of residence in the U.S. have a higher rate of viral drug-resistance associated mutations (RAMs) versus those without such a history.

Methods: Viral genotypic resistance tests obtained from 336 HIV-infected Mexican patients throughout the country were analysed for the presence of viral-RAMs and its rate was compared between migrants and non-migrants. Adjustment for potential confounders was done though a multivariate analysis.

Results: Eighty-four Mexicans who had lived for at least 3 months in the U.S. were more likely to have three or more protease inhibitor (PI)-major RAMs (aOR = 2.47; 95% CI = 1.06-5.76; p < 0.05) than in 252 individuals without this background, independently of the time spent on ART.

Conclusions: A migration background is associated with a higher likelihood of the emergence of HIV variants with decreased susceptibility to several PI.

Keywords: Drug resistance; HIV; Mexico; Protease inhibitors; Transients and Migrants.