JAC Advance Access first published online on January 24, 2008
This version published online on January 28, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm515
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Original research |
Subtype variability, virological response and drug resistance assessed on dried blood spots collected from HIV patients on antiretroviral therapy in Angola
1 Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain 2 Faculty of Medicine and Department of Infectious Diseases, Hospital Santa María, Lisbon, Portugal 3 HIV Unit, Hospital Esperança, Luanda, Angola
Received 11 August 2007; returned 8 October 2007; revised 26 November 2007; accepted 5 December 2007
* Correspondence address. Department of Infectious Diseases, Hospital Carlos III, Sinesio Delgado 10, 28029 Madrid, Spain. Tel: +34-91-4532500; Fax: +34-91-7336614; E-mail: cmendoza{at}teleline.es
Background: Subtype variability may influence treatment response and selection of drug resistance mutations in HIV-positive patients on antiretroviral therapy.
Patients and methods: A retrospective study was performed on specimens collected on dried blood spots (DBS) from HIV-positive individuals receiving antiretroviral therapy in Luanda, Angola. HIV-RNA, drug resistance mutations and subtypes were examined in 294 HIV-positive patients treated with two nucleoside analogues (NA) plus one non-nucleoside reverse transcriptase inhibitor (NNRTI).
Results: Overall, 217 (74%) had <1000 HIV-RNA copies/mL after a median of 12 months (range 7–24) of therapy. CD4 count was significantly higher in subjects with undetectable viraemia compared with viraemic patients (294 versus 220 cells/mm3; P = 0.003). Reverse transcriptase and/or gp41 genes could be genotyped in only 45 (58%) of viraemic patients, probably due to poor storage conditions of DBS. The most frequent resistance mutations were M184V (70%) and K103N (39%); 65% had mutations conferring resistance to both NA and NNRTI. Only five patients did not show resistance mutations. A wide HIV-1 subtype heterogeneity was found: 6 C (18.2%), 2 F (6%), 2 H (6%), 1 D (3%), 1 G (3%), 8 CRF02_AG (24.2%), 2 CRF06 (6%), 1 CRF01_AE (3%), 1 CRF14_BG (3%), 1 CRF25 (3%) and 1 CRF19 (3%). HIV clade could not be assigned in 7 (21%).
Conclusions: Nearly three-quarters of HIV-positive individuals who began an NNRTI-based triple regimen in Angola showed undetectable viraemia after a median of 12 months of therapy, a rate similar to that reported in Western countries. Specimens collected on DBS may allow monitoring of treatment response in resource-limited regions, although adequate temperature and humidity storage conditions are important to ensure RNA stability and further successful testing.
Key Words: DBS , viral load , HIV subtypes , non-B subtypes
The original version of this article was incorrect as it did not contain an Antiviral flag.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Johannessen, M. Troseid, and A. Calmy Dried blood spots can expand access to virological monitoring of HIV treatment in resource-limited settings J. Antimicrob. Chemother., December 1, 2009; 64(6): 1126 - 1129. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Garcia-Lerma, A. McNulty, C. Jennings, D. Huang, W. Heneine, and J. W. Bremer Rapid decline in the efficiency of HIV drug resistance genotyping from dried blood spots (DBS) and dried plasma spots (DPS) stored at 37{degrees}C and high humidity J. Antimicrob. Chemother., July 1, 2009; 64(1): 33 - 36. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Bartolo, C. Rocha, J. Bartolomeu, A. Gama, M. Fonseca, A. Mendes, F. Cristina, S. Thamm, M. Epalanga, P. C. Silva, et al. Antiretroviral Drug Resistance Surveillance among Treatment-Naive Human Immunodeficiency Virus Type 1-Infected Individuals in Angola: Evidence for Low Level of Transmitted Drug Resistance Antimicrob. Agents Chemother., July 1, 2009; 53(7): 3156 - 3158. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Buckton, S. L. Bissett, R. E. Myers, S. Beddows, S. Edwards, P. A. Cane, and D. Pillay Development and optimization of an internally controlled dried blood spot assay for surveillance of human immunodeficiency virus type-1 drug resistance J. Antimicrob. Chemother., December 1, 2008; 62(6): 1191 - 1198. [Abstract] [Full Text] [PDF]
|
|