HIV transmitted drug resistance in adult and pediatric populations in Panama

Juan Castillo, Griselda Arteaga, Yaxelis Mendoza, Alexander A. Martínez, Rigoberto Samaniego, Dora Estripeaut, Kathleen R. Page, Rebecca E. Smith, Nestor Sosa, Juan M. Pascale

Research output: Contribution to journalArticle

Abstract

Objective. To investigate the prevalence of transmitted drug-resistant HIV among adults in Panama by using a modified World Health Organization Threshold Survey (WHO-TS) and to investigate rates of initial resistance among HIV-positive infants in Panama. Methods. At the Gorgas Memorial Institute, 47 HIV-positive adults were genotyped for mutations associated with transmitted drug resistance (TDR) in the reverse transcriptase and protease genes of HIV-1, according to WHO-TS guidelines, modified to include patients ≤ 26 years old. Prevalence rates for drug-resistance mutations against three classes of antiretroviral drugs-nucleoside analog reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors-were calculated as low (< 5.0%), moderate (5.0%-15.0%), and high (> 15.0%). Twenty-five infant patients were also genotyped and prevalence rates for drug-resistance mutations were calculated. Results. TDR among Panamanian adults was moderate: 6 of 47 HIV-positive adults showed one or more mutations associated with TDR. Horizontal TDR mutations were moderate for NRTIs and NNRTIs and low for protease inhibitors. Vertical transmission of HIV in Panama has decreased for 2002-2007, but vertical HIV TDR prevalence is moderate (12.0%) and is emerging as a problem due to incomplete antiretroviral coverage in pregnancy. Conclusions. The prevalence of HIV TDR indicated by this study, combined with known rates of HIV infection in Panama, suggests more extensive surveys are needed to identify risk factors associated with transmission of HIV drug resistance. Specific WHO-TS guidelines for monitoring vertical transmission of drug-resistant HIV should be established.

Original languageEnglish (US)
Pages (from-to)649-656
Number of pages8
JournalRevista Panamericana de Salud Publica/Pan American Journal of Public Health
Volume30
Issue number6
DOIs
StatePublished - Dec 1 2011

Keywords

  • Antiretroviral therapy, highly active
  • Drug resistance
  • HIV-1
  • Infectious disease transmission, vertical
  • Panama
  • Protease inhibitors

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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  • Cite this

    Castillo, J., Arteaga, G., Mendoza, Y., Martínez, A. A., Samaniego, R., Estripeaut, D., Page, K. R., Smith, R. E., Sosa, N., & Pascale, J. M. (2011). HIV transmitted drug resistance in adult and pediatric populations in Panama. Revista Panamericana de Salud Publica/Pan American Journal of Public Health, 30(6), 649-656. https://doi.org/10.1590/S1020-49892011001200025