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HIV Pretreatment Drug Resistance Trends in Mexico City, 2017–2020
In response to increasing pretreatment drug resistance (PDR), Mexico changed its national antiretroviral treatment (ART) policy, recommending and procuring second-generation integrase strand-transfer inhibitor (INSTI)-based regimens as preferred first-line options since 2019. We present a four-year...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708254/ https://www.ncbi.nlm.nih.gov/pubmed/34959542 http://dx.doi.org/10.3390/pathogens10121587 |
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author | García-Morales, Claudia Tapia-Trejo, Daniela Matías-Florentino, Margarita Quiroz-Morales, Verónica Sonia Dávila-Conn, Vanessa Beristain-Barreda, Ángeles Cárdenas-Sandoval, Miroslava Becerril-Rodríguez, Manuel Iracheta-Hernández, Patricia Macías-González, Israel García-Mendiola, Rebecca Guzmán-Carmona, Alejandro Zarza-Sánchez, Eduardo Cruz, Raúl Adrián González-Rodríguez, Andrea Reyes-Terán, Gustavo Ávila-Ríos, Santiago |
author_facet | García-Morales, Claudia Tapia-Trejo, Daniela Matías-Florentino, Margarita Quiroz-Morales, Verónica Sonia Dávila-Conn, Vanessa Beristain-Barreda, Ángeles Cárdenas-Sandoval, Miroslava Becerril-Rodríguez, Manuel Iracheta-Hernández, Patricia Macías-González, Israel García-Mendiola, Rebecca Guzmán-Carmona, Alejandro Zarza-Sánchez, Eduardo Cruz, Raúl Adrián González-Rodríguez, Andrea Reyes-Terán, Gustavo Ávila-Ríos, Santiago |
author_sort | García-Morales, Claudia |
collection | PubMed |
description | In response to increasing pretreatment drug resistance (PDR), Mexico changed its national antiretroviral treatment (ART) policy, recommending and procuring second-generation integrase strand-transfer inhibitor (INSTI)-based regimens as preferred first-line options since 2019. We present a four-year observational study describing PDR trends across 2017–2020 at the largest HIV diagnosis and primary care center in Mexico City. A total of 6688 baseline protease-reverse transcriptase and 6709 integrase sequences were included. PDR to any drug class was 14.4% (95% CI, 13.6–15.3%). A significant increasing trend for efavirenz/nevirapine PDR was observed (10.3 to 13.6%, p = 0.02). No increase in PDR to second-generation INSTI was observed, remaining under 0.3% across the study period. PDR was strongly associated with prior exposure to ART (aOR: 2.9, 95% CI: 1.9–4.6, p < 0.0001). MSM had higher odds of PDR to efavirenz/nevirapine (aOR: 2.0, 95% CI: 1.0–3.7, p = 0.04), reflecting ongoing transmission of mutations such as K103NS and E138A. ART restarters showed higher representation of cisgender women and injectable drug users, higher age, and lower education level. PDR to dolutegravir/bictegravir remained low in Mexico City, although further surveillance is warranted given the short time of ART optimization. Our study identifies demographic characteristics of groups with higher risk of PDR and lost to follow-up, which may be useful to design differentiated interventions locally. |
format | Online Article Text |
id | pubmed-8708254 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87082542021-12-25 HIV Pretreatment Drug Resistance Trends in Mexico City, 2017–2020 García-Morales, Claudia Tapia-Trejo, Daniela Matías-Florentino, Margarita Quiroz-Morales, Verónica Sonia Dávila-Conn, Vanessa Beristain-Barreda, Ángeles Cárdenas-Sandoval, Miroslava Becerril-Rodríguez, Manuel Iracheta-Hernández, Patricia Macías-González, Israel García-Mendiola, Rebecca Guzmán-Carmona, Alejandro Zarza-Sánchez, Eduardo Cruz, Raúl Adrián González-Rodríguez, Andrea Reyes-Terán, Gustavo Ávila-Ríos, Santiago Pathogens Article In response to increasing pretreatment drug resistance (PDR), Mexico changed its national antiretroviral treatment (ART) policy, recommending and procuring second-generation integrase strand-transfer inhibitor (INSTI)-based regimens as preferred first-line options since 2019. We present a four-year observational study describing PDR trends across 2017–2020 at the largest HIV diagnosis and primary care center in Mexico City. A total of 6688 baseline protease-reverse transcriptase and 6709 integrase sequences were included. PDR to any drug class was 14.4% (95% CI, 13.6–15.3%). A significant increasing trend for efavirenz/nevirapine PDR was observed (10.3 to 13.6%, p = 0.02). No increase in PDR to second-generation INSTI was observed, remaining under 0.3% across the study period. PDR was strongly associated with prior exposure to ART (aOR: 2.9, 95% CI: 1.9–4.6, p < 0.0001). MSM had higher odds of PDR to efavirenz/nevirapine (aOR: 2.0, 95% CI: 1.0–3.7, p = 0.04), reflecting ongoing transmission of mutations such as K103NS and E138A. ART restarters showed higher representation of cisgender women and injectable drug users, higher age, and lower education level. PDR to dolutegravir/bictegravir remained low in Mexico City, although further surveillance is warranted given the short time of ART optimization. Our study identifies demographic characteristics of groups with higher risk of PDR and lost to follow-up, which may be useful to design differentiated interventions locally. MDPI 2021-12-08 /pmc/articles/PMC8708254/ /pubmed/34959542 http://dx.doi.org/10.3390/pathogens10121587 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article García-Morales, Claudia Tapia-Trejo, Daniela Matías-Florentino, Margarita Quiroz-Morales, Verónica Sonia Dávila-Conn, Vanessa Beristain-Barreda, Ángeles Cárdenas-Sandoval, Miroslava Becerril-Rodríguez, Manuel Iracheta-Hernández, Patricia Macías-González, Israel García-Mendiola, Rebecca Guzmán-Carmona, Alejandro Zarza-Sánchez, Eduardo Cruz, Raúl Adrián González-Rodríguez, Andrea Reyes-Terán, Gustavo Ávila-Ríos, Santiago HIV Pretreatment Drug Resistance Trends in Mexico City, 2017–2020 |
title | HIV Pretreatment Drug Resistance Trends in Mexico City, 2017–2020 |
title_full | HIV Pretreatment Drug Resistance Trends in Mexico City, 2017–2020 |
title_fullStr | HIV Pretreatment Drug Resistance Trends in Mexico City, 2017–2020 |
title_full_unstemmed | HIV Pretreatment Drug Resistance Trends in Mexico City, 2017–2020 |
title_short | HIV Pretreatment Drug Resistance Trends in Mexico City, 2017–2020 |
title_sort | hiv pretreatment drug resistance trends in mexico city, 2017–2020 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708254/ https://www.ncbi.nlm.nih.gov/pubmed/34959542 http://dx.doi.org/10.3390/pathogens10121587 |
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