Genotypic Resistance Profile to Antiretrovirals in Children and Adolescents With Human Immunodeficiency Virus in a Reference Hospital in the Southern Region of Brazil

Abstract

Background: Limited data on the genotypic resistance profile in children and adolescents with human immunodeficiency virus type 1 (HIV-1) can lead to incorrect use of antiretroviral therapy (ART) and facilitate therapeutic failure when using the treatment recommended as the first line. The southern region of Brazil, one of the main pockets of subtype C, does not have consistent data for this age group. The aim of this study is to determine the genotypic resistance profile of children and adolescents with HIV in a reference hospital in the southern region of Brazil.

Methods: A cross-sectional study was carried out with children and/or adolescents with HIV being monitored at a reference hospital in Brazil. Demographic, clinical and laboratory variables were analyzed.

Results: The mean age of the patients was 7.95 years. Drug resistance mutation (DRM) was observed in 47.72% (21/44), 61.9% identified in nucleoside reverse transcriptase inhibitors (NRTIs), 80.95% for non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 14.29% for protease inhibitors (PIs). The most frequent major mutations by class were M184V and K103N.These mutations were not found for PIs. There was a prevalence of the use of triple antiretroviral therapy. Ninety point nine percent of the viral subtype was HIV-1C. The antiretrovirals that showed the most resistance were efavirenz and nevirapine.

Conclusions: Viral subtype C was responsible for most infections and almost half of the population surveyed had at least one resistance mutation. We demonstrate resistance to drugs recommended as the first line and used to prevent mother-to-child transmission. We need to pay attention to the management of ART in children and adolescents since the options are limited and the time of use is longer.

Clin Infect Immun. 2020;5(3):59-65
doi: https://doi.org/10.14740/cii117