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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Rev. chil. pediatr. vol.82 no.5 Santiago oct. 2011

http://dx.doi.org/10.4067/S0370-41062011000500014 

Rev Chil Pediatr 2011; 82 (5): 462

CONO SUR
SOUTH CONE OF AMERICA

Esta sección contiene los artículos originales de las Revistas de Pediatría de las Sociedades de Pediatría del Cono Sur seleccionados en el XV encuentro de Editores, Asunción, Paraguay 2010, para ser publicados por los países integrantes . durante el año 2011.

Diversity and prevalence of antiretroviral genotypic resistance mutations among HIV-1-infected children

 

Flávia J. Almeida1, Eitan N. Berezin2, Rosángela Rodrigues3, Marco A. P. Sáfadi4, Mariana V. Arnoni5, Cristina Oliveira6, Luis F. M. Brígido7

1. Médica assistente, Serviço de Infectología Pediátrica, Santa Casa de São Paulo, São Paulo, SP, Brazil.

2. Médico responsável, Serviço de Infectología Pediátrica, Santa Casa de São Paulo, São Paulo, SP, Brazil.

3. Médica responsável, Laboratório de Genotipagem, Instituto Adolfo Lutz, São Paulo, SP, Brazil.

4. Médico assistente, Serviço de Infectología Pediátrica, Santa Casa de São Paulo, São Paulo, SP, Brazil.

5. Médica pós-graduanda, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil.

6. Biomédica, Laboratório de Genotipagem, Instituto Adolfo Lutz, São Paulo, SP, Brazil.

7. Médico, Laboratório de Genotipagem, Instituto Adolfo Lutz, São Paulo, SP, Brazil.


ABSTRACT

Objective: To evaluate genotyping and subtyping in antiretroviral (ARV) na1ve and experienced children, as well as drug resistance profiles through genotyping in these children. Methods: This retrospective study assessed ARV-na1ve HIV children and HIV children failing highly active antiretroviral treatment (HAART) followed up at Santa Casa de São Paulo. Genotyping was performed using purified polymerase chain reaction (PCR) products from retrotranscribed RNA using Kit Viroseq HIV-1 Genotyping System 2.0 or nested PCR in-house. Sequencingwas performed using automatic equipment (ABI 3100). ARV resistance mutations were analyzed in the Stanford HIV Drug Resistance Database and subtyping was performed at the National Center for Biotechnology Information (NCBI), using SimPlot analysis, together with phylogenetic analysis. Results: No primary ARV resistance mutation was detected in the 24 ARV-na1ve children, although there were mutations that may contribute to resistance to nucleoside analogue reverse transcriptase inhibitors (NRTI) (12.5%) and to protease inhibitors (PI) (95.8%). For the 23 children failing HAART, we found ARV resistance mutations to NRTI in 95.6% and to non-nucleoside analogue reverse transcriptase inhibitors (NNRTI) in 60.8%. For PI, we found ARV resistance mutations in 95.7%, 47.8% of which had only polymorfisms. In the subtyping analyses, 78.3% of the sequences clustered in HIV-1 subtype B, 4.3% in C, 13% in F and 4.4% in recombinant forms. Conclusion: Our results show low rates of primary resistance in ARV-na1ve children and high rates of resistance in children failing ARV treatment, which is compatible with ARV use in these patients.

(Key words: HIV, resistance, genotype, child, antiretroviral therapy). J Pediatr (Rio J). 2009;85(2):104-109


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Correspondencia a: Flávia J. Almeida E-mail: flaviaja@gmail.com