Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique.
Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique.
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DOI：
10.1371/journal.pone.0068213
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Jani IV
中科院分区：
文献类型：
--
作者：
Bila DC;Young P;Merks H;Vubil AS;Mahomed M;Augusto A;Abreu CM;Mabunda NJ;Brooks JI;Tanuri A;Jani IV
在莫桑比克，2004年采用了高效抗逆转录病毒疗法，随后进行了权力下放和推广，到2009年，覆盖面增加了20倍以上。开展艾滋病毒耐药性阈值调查（HIVDR-TS）至关重要，以监测传播病毒耐药性的出现，并提出基于证据的建议，支持莫桑比克的抗逆转录病毒政策。采用世界卫生组织（WHO）的方法，评价马普托和贝拉产前门诊新诊断的HIV-1感染孕妇对非核苷类逆转录酶抑制剂（NNRTI）、核苷类逆转录酶抑制剂（NRTI）和蛋白酶抑制剂（PI）的传播性耐药（TDR）。使用REGA HIV-1亚型分型工具分配亚型，并使用MEGA版本5构建系统发育树。虽然在这些调查中检测到与对所有三种药物的耐药性相关的突变，但在马普托对所有三类药物的两次调查中，对传播的耐药性进行了分析并归类为<5%。2009年贝拉的NNRTI耐药传播率在5- 15%之间，比2007年增加，当时没有发现NNRTI突变。我们的研究结果表明，流行病主要是C亚型，其中基于两个NRTI和一个NNRTI的一线选择仍然是有效的治疗艾滋病毒感染，但在贝拉发现的中间水平的TDR加强需要不断评估与继续治疗扩展在莫桑比克。
In Mozambique, highly active antiretroviral treatment (HAART) was introduced in 2004 followed by decentralization and expansion, resulting in a more than 20-fold increase in coverage by 2009. Implementation of HIV drug resistance threshold surveys (HIVDR-TS) is crucial in order to monitor the emergence of transmitted viral resistance, and to produce evidence-based recommendations to support antiretroviral (ARV) policy in Mozambique. World Health Organization (WHO) methodology was used to evaluate transmitted drug resistance (TDR) in newly diagnosed HIV-1 infected pregnant women attending ante-natal clinics in Maputo and Beira to non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitors (PI). Subtypes were assigned using REGA HIV-1 subtyping tool and phylogenetic trees constructed using MEGA version 5. Although mutations associated with resistance to all three drug were detected in these surveys, transmitted resistance was analyzed and classified as <5% in Maputo in both surveys for all three drug classes. Transmitted resistance to NNRTI in Beira in 2009 was classified between 5–15%, an increase from 2007 when no NNRTI mutations were found. All sequences clustered with subtype C. Our results show that the epidemic is dominated by subtype C, where the first-line option based on two NRTI and one NNRTI is still effective for treatment of HIV infection, but intermediate levels of TDR found in Beira reinforce the need for constant evaluation with continuing treatment expansion in Mozambique.
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DOI：
10.1097/01.qai.0000196666.16616.fe
发表时间：
2006-05-01
影响因子：
3.6
作者：
Jayaraman, GC;Archibald, CP;Sandstrom, P
通讯作者：
Sandstrom, P
影响因子：
3.8
作者：
Perno, CF;Cozzi-Lepri, A;d'Arminio-Monforte, A
通讯作者：
d'Arminio-Monforte, A
影响因子：
2.7
作者：
Abreu, Celina Monteiro;Brindeiro, Patricia A.;Brindeiro, Rodrigo de Moraes
通讯作者：
Brindeiro, Rodrigo de Moraes
影响因子：
3.7
作者：
Bennett DE;Camacho RJ;Otelea D;Kuritzkes DR;Fleury H;Kiuchi M;Heneine W;Kantor R;Jordan MR;Schapiro JM;Vandamme AM;Sandstrom P;Boucher CA;van de Vijver D;Rhee SY;Liu TF;Pillay D;Shafer RW
通讯作者：
Shafer RW
影响因子：
3.7
作者：
Auld, Andrew F.;Mbofana, Francisco;Ellerbrock, Tedd
通讯作者：
Ellerbrock, Tedd