HIV transmitted drug resistance in adult and pediatric populations in Panama Farmacorresistencia transmitida del VIH en poblaciones adultas y pediátricas en Panamá

• Main Authors: Juan Castillo, Griselda Arteaga, Yaxelis Mendoza, Alexander A. Martínez, Rigoberto Samaniego, Dora Estripeaut, Kathleen R. Page, Rebecca E. Smith, Nestor Sosa, Juan M. Pascale
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2011
• Subjects: VIH-1; resistencia a medicamentos; transmisión vertical de enfermedad infecciosa; inhibidores de proteasas; terapia antirretroviral altamente activa; Panamá; HIV-1; drug resistance; infectious disease transmission; vertical; protease inhibitors; antiretroviral therapy; highly active; Panama; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/866d36167df94c648d5390a3e91ca0da

OBJECTIVE: To investigate the prevalence of transmitted drug-resistant HIV among adults in Panama by using a modified World Health Organization Threshold Survey (WHO-TS) and to investigate rates of initial resistance among HIV-positive infants in Panama. METHODS: At the Gorgas Memorial Institute, 47 HIV-positive adults were genotyped for mutations associated with transmitted drug resistance (TDR) in the reverse transcriptase and protease genes of HIV-1, according to WHO-TS guidelines, modified to include patients ≤ 26 years old. Prevalence rates for drug-resistance mutations against three classes of antiretroviral drugs-nucleoside analog reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors-were calculated as low (< 5.0%), moderate (5.0%-15.0%), and high (> 15.0%). Twenty-five infant patients were also geno-typed and prevalence rates for drug-resistance mutations were calculated. RESULTS: TDR among Panamanian adults was moderate: 6 of 47 HIV-positive adults showed one or more mutations associated with TDR. Horizontal TDR mutations were moderate for NRTIs and NNRTIs and low for protease inhibitors. Vertical transmission of HIV in Panama has decreased for 2002-2007, but vertical HIV TDR prevalence is moderate (12.0%) and is emerging as a problem due to incomplete antiretroviral coverage in pregnancy. CONCLUSIONS: The prevalence of HIV TDR indicated by this study, combined with known rates of HIV infection in Panama, suggests more extensive surveys are needed to identify risk factors associated with transmission of HIV drug resistance. Specific WHO-TS guidelines for monitoring vertical transmission of drug-resistant HIV should be established. OBJETIVO: Investigar la prevalencia de farmacorresistencia transmitida del VIH en adultos en Panamá mediante un estudio del umbral modificado de la Organización Mundial de la Salud (OMS) e investigar las tasas de resistencia inicial en lactantes seropositivos para el VIH en Panamá. MÉTODOS: En el ...