Carlos Henrique Valente Moreira1,2, Tassila Salomon2, Cecília S Alencar3, Thelma T Gonçalez4, Ester C Sabino2, Liliana Preiss5, Paula Loureiro6, Maria Esther Lopes7, Carolina Miranda Teixeira8, Mariana Mundim7, Anna Barbara Carneiro-Proietti8, Cesar de Almeida-Neto9,10, Brian Custer4,11. 1. Instituto de Infectologia "Emílio Ribas", São Paulo, Brazil. 2. Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil. 3. Laboratório de Medicina Laboratorial LIM 03- HCFMUSP, São Paulo, Brazil. 4. Vitalant Research Institute, San Francisco, California, USA. 5. RTI - Research Triangle Institute, Durham, North Carolina, USA. 6. Fundação HEMOPE, Recife, Brazil. 7. Fundação HEMORIO, Rio de Janeiro, Brazil. 8. Fundação HEMOMINAS, Belo Horizonte, Brazil. 9. Departamento de Aféreses, Fundação Pró-Sangue, Hemocentro de São Paulo, Sao Paulo, Brazil. 10. Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 11. Department of Laboratory Medicine, UCSF, San Francisco, California, USA.
Abstract
BACKGROUND: Acquisition of HIV primary drug resistant (PDR) infection can lead to poor virologic and clinical outcomes in individuals and hampers public health efforts in epidemic control. Monitoring PDR in HIV-positive blood donors can be used to inform nationwide trends in the spread of drug-resistant HIV strains. METHODS: We conducted a cross-sectional study using genetic sequence analysis to assess HIV pol sequences, PDR, and risk factors for infection using audio computer-assisted structured interviews in four large blood centers in Brazil from 2007 to 2017. RESULTS: Of 716 HIV-positive blood donors, 504 (70.4%) were successfully sequenced. HIV clade B (73.2%) was the most prevalent subtype, followed by a mix of non-B (21.2%) sub-types. A twofold increase (from 4% to 8%) in recombinants prevalence was observed during the study period. Sixty-four (12.7%) presented PDR. Overall, HIV PDR prevalence remained stable during the study period. Drug resistance mutations for non-nucleoside reverse transcriptase inhibitors were found in 39 (7.7%) donors, while for nucleoside reverse transcriptase inhibitors were found in 26 (5.1%), and for protease inhibitors in 24 (4.8%) of HIV-infected donors. We did not find statistically significant differences in demographics, behavioural risk factors, or HIV genotypes when comparing volunteers with and without PDR. CONCLUSION: The HIV PDR rate among donors remained stable during the study period. HIV-positive blood donors can be an informative population to monitor primary HIV resistance and ultimately may help to increase the knowledge and awareness of HIV risk factors and PDR.
BACKGROUND: Acquisition of HIV primary drug resistant (PDR) infection can lead to poor virologic and clinical outcomes in individuals and hampers public health efforts in epidemic control. Monitoring PDR in HIV-positive blood donors can be used to inform nationwide trends in the spread of drug-resistant HIV strains. METHODS: We conducted a cross-sectional study using genetic sequence analysis to assess HIV pol sequences, PDR, and risk factors for infection using audio computer-assisted structured interviews in four large blood centers in Brazil from 2007 to 2017. RESULTS: Of 716 HIV-positive blood donors, 504 (70.4%) were successfully sequenced. HIV clade B (73.2%) was the most prevalent subtype, followed by a mix of non-B (21.2%) sub-types. A twofold increase (from 4% to 8%) in recombinants prevalence was observed during the study period. Sixty-four (12.7%) presented PDR. Overall, HIV PDR prevalence remained stable during the study period. Drug resistance mutations for non-nucleoside reverse transcriptase inhibitors were found in 39 (7.7%) donors, while for nucleoside reverse transcriptase inhibitors were found in 26 (5.1%), and for protease inhibitors in 24 (4.8%) of HIV-infected donors. We did not find statistically significant differences in demographics, behavioural risk factors, or HIV genotypes when comparing volunteers with and without PDR. CONCLUSION: The HIV PDR rate among donors remained stable during the study period. HIV-positive blood donors can be an informative population to monitor primary HIV resistance and ultimately may help to increase the knowledge and awareness of HIV risk factors and PDR.
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