scholarly journals Overview of genotypic and clinical profiles of human immunodeficiency virus type 1-infected children in Rio de Janeiro, Brazil

2004 ◽  
Vol 76 (4) ◽  
pp. 727-741 ◽  
Author(s):  
Elizabeth S. Machado ◽  
John S. Lambert ◽  
Adriana O. Afonso ◽  
Silvia M. Cunha ◽  
Ricardo H. Oliveira ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Rio De Janeiro ◽  
Hiv Transmission ◽  
Clinical Laboratory ◽  
Adult Population ◽  
Developed Countries ◽  
Pediatric Hiv ◽  
Resistance Mutations ◽  
Drug Naïve ◽  
Hiv 1

Although mother-to-child HIV transmission prevention has slowed down pediatric HIV infection in developed countries, large numbers of infants still become infected in developing nations. Data on pediatric HIV infection is however largely scarce. In this study, we have overviewed clinical, laboratory and genotypic data from a large cohort of HIV-infected infants regularly followed at two pediatric HIV outpatient clinics in Rio de Janeiro, Brazil. Children on antiretroviral therapy, as well as drug-naïve, newly diagnosed infants were analyzed. Prevalence of drug resistance mutations, as well as immunological and virological responses to therapy were evaluated. Additionally, HIV-1 subtype frequencies and their distribution over the course of the epidemic were studied. We have found a high prevalence of mutations among ARV-experienced children, whereas mutations were absent in the drug-naïve group. Despite the high levels of resistance among treated infants, an important improvement of their immunological status was observed. HIV-1 subtype distribution followed the trends of the adult population, with the appearance of non-B subtypes and recombinant forms after 1990. To our knowledge, this is the largest pediatric cohort ever analyzed in Brazil, and the data provided is of paramount importance to a better understanding of HIV/AIDS evolution in pediatric settings.

scholarly journals Update on Prevention of Mother-to-Child HIV Transmission

2004 ◽  
Vol 12 (3-4) ◽  
pp. 152-213
Author(s):  
Lynne M. Mofenson
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Standard Of Care ◽  
Perinatal Transmission ◽  
Developed Countries ◽  
Pediatric Hiv ◽  
The Us ◽  
The Impact

The pediatric HIV epidemic in the US and other more developed countries changed dramatically after February 1994, when the results of PACTG 076 demonstrated that a triple regimen of ZDV reduced the risk of perinatal transmission by nearly 70%. Incorporation of ZDV prophylaxis into clinical practice, together with increased prenatal HIV counseling and testing, rapidly resulted in a significant decline in perinatal transmission and a concomitant decrease in the number of reported pediatric AIDS cases in the US. Transmission rates of 3–6% have been reported in various cohort studies with ZDV prophylaxis alone, and of 1–2% when ZDV is combined with elective Cesarean delivery or when women are treated with highly active antiretroviral regimens that reduce maternal viral load to unquantifiable levels. Additionally, several short antiretroviral regimens, including those that require administration only during the intrapartum and early postpartum periods, have been shown to decrease perinatal transmission. These regimens provide effective intervention even for HIV-infected pregnant women who have not received antiretroviral therapy and are identified late in pregnancy or for the first time at delivery through rapid HIV testing.However, this success has been partially offset by increasing HIV infection rates among young women, high adolescent pregnancy rates among at-risk populations, continued failure to identify HIV infection during pregnancy and inadequate prenatal care among HIV-infected women, particularly those using drugs. Additionally, the impact of evolving patterns of antiretroviral drug resistance on efficacy of prophylaxis is not known. As combination antiretroviral therapy becomes the standard of care for pregnant women in developed countries, evaluation of their infants for short- or long-term adverse consequences of intrauterine antiretroviral exposure is also a priority. Finally, clinical trials have identified short-course antiretroviral prophylaxis regimens that are effective and safe in resource-poor countries; however, transmission of HIV via breast milk remains a concern.

scholarly journals Transmitted drug resistance to Tenofovir/Emtricitabine among persons with newly diagnosed HIV infection in Shenyang city, Northeast China from 2016 to 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhen Wang ◽  
Bin Zhao ◽  
Minghui An ◽  
Wei Song ◽  
Xue Dong ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Hiv Infection ◽  
Northeast China ◽  
Transmitted Drug Resistance ◽  
Newly Diagnosed ◽  
Resistance Mutations ◽  
Shenyang City ◽  
Subtype B ◽  
Recent Hiv Infection ◽  
Hiv 1

Abstract Background To assess transmitted drug resistance (TDR) to tenofovir (TDF)/emtricitabine (FTC), using as pre-exposure prophylaxis, among newly diagnosed human immunodeficiency virus-1 (HIV-1)-infected residents in Shenyang city, northeast China. Methods Demographic and epidemiological information of all newly diagnosed HIV-1 infected residents in Shenyang city from 2016 to 2018 were anonymously collected from the local HIV epidemic database. HIV-1 pol sequences were amplified from RNA in cryopreserved plasma samples and sequenced directly. Viral subtypes were inferred with phylogenetic analysis and drug resistance mutations (DRMs) were determined according to the Stanford HIVdb algorithm. Recent HIV infection was determined with HIV Limiting Antigen avidity electro immunoassay. Results A total of 2176 sequences (92.4%, 2176/2354) were obtained; 70.9% (1536/2167) were CRF01_AE, followed by CRF07_BC (18.0%, 391/2167), subtype B (4.7%, 102/2167), other subtypes (2.6%, 56/2167), and unique recombinant forms (3.8%, 82/2167). The prevalence of TDR was 4.9% (107/2167), among which, only 0.6% (13/2167) was resistance to TDF/FTC. Most of these subjects had CRF01_AE strains (76.9%, 10/13), were unmarried (76.9%, 10/13), infected through homosexual contact (92.3%, 12/13), and over 30 years old (median age: 33). The TDF/FTC DRMs included K65R (8/13), M184I/V (5/13), and Y115F (2/13). Recent HIV infection accounted for only 23.1% (3/13). Most cases were sporadic in the phylogenetic tree, except two CRF01_AE sequences with K65R (Bootstrap value: 99%). Conclusions The prevalence of TDR to TDF/FTC is low among newly diagnosed HIV-infected cases in Shenyang, suggesting that TDR may have little impact on the protective effect of the ongoing CROPrEP project in Shenyang city.

scholarly journals P2.22 Surveillance of hiv-1 transmitted drug resistance among drug-naïve populations in rio de janeiro, brazil

2017 ◽  
Author(s):  
José Carlos Couto Fernandez ◽  
Giovanni Ravasi ◽  
Michelle Das Neves ◽  
Jose Henrique Pilotto ◽  
Carlos Silva de Jesus ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Rio De Janeiro ◽  
Transmitted Drug Resistance ◽  
Drug Naïve ◽  
Hiv 1

scholarly journals To study the prevalence of HIV infection amongst antenatal women in a tertiary care hospital in Gujarat, India

2017 ◽  
Vol 6 (9) ◽  
pp. 3872
Author(s):  
Mahima Jain ◽  
Bhargavkumar K. Nimavat
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Tertiary Care Hospital ◽  
Adult Population ◽  
Tertiary Care ◽  
Rapid Test ◽  
Antiretroviral Drugs ◽  
Care Hospital ◽  
Age Group ◽  
Persons Living With Hiv

Background: India has an estimated 2.1 million persons living with HIV in 2011. The prevalence of HIV among adult population has consistently declined over the last one decade from 0.4% in 2000 to 0.27% in 2011.HIV transmission from infected mother to baby is known to occur. The effective use of Antiretroviral drugs is known to reduce the risk significantly.Methods: This is a retrospective data analysis to know the prevalence of HIV infection among antenatal women attending a tertiary care hospital. All antenatal females are offered pretest counseling, sample collected and tested as per NACO guidelines by Rapid test and ELISA. Results of the test are disclosed after posttest counseling and kept confidential.Results: The seroprevalence over five years in the present study ranges from 0.466% to 0.278%. Women in the age group 21-25 years shows high prevalence due to peak sexual activity in this age group. 56.66% Husbands of these females are reactive which shows the major source of infection.Conclusions: The present study stresses the need to target the population mainly between 21-30 years in various Government programmes, thereby to reduce the transmission from parent to child.

scholarly journals Evaluation of HIV Transmission Clusters among Natives and Foreigners Living in Italy

Viruses ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 791 ◽  
Author(s):  
Lavinia Fabeni ◽  
Maria Mercedes Santoro ◽  
Patrizia Lorenzini ◽  
Stefano Rusconi ◽  
Nicola Gianotti ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Phylogenetic Analyses ◽  
Hiv Infections ◽  
Public Health Response ◽  
Health Response ◽  
Drug Naïve ◽  
Recent Diagnosis ◽  
Sex With Men ◽  
Italian Origin ◽  
Hiv 1

We aimed at evaluating the characteristics of HIV-1 molecular transmission clusters (MTCs) among natives and migrants living in Italy, diagnosed between 1998 and 2018. Phylogenetic analyses were performed on HIV-1 polymerase (pol) sequences to characterise subtypes and identify MTCs, divided into small (SMTCs, 2–3 sequences), medium (MMTCs, 4–9 sequences) and large (LMTCs, ≥10 sequences). Among 3499 drug-naïve individuals enrolled in the Italian Cohort Naive Antiretroviral (ICONA) cohort (2804 natives; 695 migrants), 726 (20.8%; 644 natives, 82 migrants) were involved in 228 MTCs (6 LMTCs, 36 MMTCs, 186 SMTCs). Migrants contributed 14.4% to SMTCs, 7.6% to MMTCs and 7.1% to LMTCs, respectively. HIV-1 non-B subtypes were found in 51 MTCs; noteworthy was that non-B infections involved in MTCs were more commonly found in natives (n = 47) than in migrants (n = 4). Factors such as Italian origin, being men who have sex with men (MSM), younger age, more recent diagnosis and a higher CD4 count were significantly associated with MTCs. Our findings show that HIV-1 clustering transmission among newly diagnosed individuals living in Italy is prevalently driven by natives, mainly MSM, with a more recent diagnosis and frequently infected with HIV-1 non-B subtypes. These results can contribute to monitoring of the HIV epidemic and guiding the public health response to prevent new HIV infections.

Antiretroviral agents: Focus on Maraviroc for the Treatment of HIV-1-Infected Adults

2010 ◽  
Vol 2 ◽  
pp. CMT.S5420
Author(s):  
SL. Pett ◽  
S. Emery ◽  
AD. Kelleher ◽  
DA. Cooper
Keyword(s):  
Hiv Infection ◽  
Chemokine Receptors ◽  
Hiv Transmission ◽  
Hiv Therapy ◽  
Ccr5 Receptor ◽  
Tick Borne Encephalitis ◽  
Hiv Entry ◽  
Orally Bioavailable ◽  
Hiv Envelope ◽  
Hiv 1

Over a decade has passed since several groups identified the chemokine receptors CXCR4 and CCR5 as key co-receptors for HIV entry. CCR5 is more important in HIV transmission and during the early course of HIV infection. It is also apparent that protection from HIV infection is afforded to those lacking CCR5–-the so called delta-32 homozygotes; in those heterozygous for this mutation, an attenuated course of HIV-infection is observed. Provocatively, those with modified expression of CCR5 are physiologically normal with the exception of poorer outcomes with some of the viral encephalitides specifically West Nile virus and Tick Borne encephalitis. The small molecule, orally-bioavailable CCR5 receptor antagonists, including, maraviroc (MVC), are allosteric inhibitors that lock the CCR5 receptor into a conformation such that the receptor is not able to bind HIV envelope protein; the molecules also variably block intracellular signalling induced by different receptor-binding chemokines. The aims of this review on the CCR5 receptor inhibitors are to summarise information relevant to treatment in individuals with HIV-1 infection. Data from the licensing studies, the side-effect profile and putative long-term risks of CCR5 receptor inhibitor exposure, tropism testing and mechanisms of resistance will be reviewed. The potential for using this class of agent as an immunomodulating agent will be detailed. Given that MVC is the only licensed drug in this class at present and reflecting the greater body of work describing this agent, the majority of information in this review relates to MVC. Last, the authors propose the place of MVC in the hierarchy of HIV therapy and future opportunities for research.

scholarly journals Stochastic investigation of HIV infection and the emergence of drug resistance

2021 ◽  
Vol 19 (2) ◽  
pp. 1174-1194
Author(s):  
Damilola Olabode ◽  
◽  
Libin Rong ◽  
Xueying Wang ◽  
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Stochastic Models ◽  
Early Stage ◽  
Critical Role ◽  
Resistance Mutations ◽  
Multitype Branching Process ◽  
Increased Risk ◽  
Hiv 1

<abstract><p>Drug-resistant HIV-1 has caused a growing concern in clinic and public health. Although combination antiretroviral therapy can contribute massively to the suppression of viral loads in patients with HIV-1, it cannot lead to viral eradication. Continuing viral replication during sub-optimal therapy (due to poor adherence or other reasons) may lead to the accumulation of drug resistance mutations, resulting in an increased risk of disease progression. Many studies also suggest that events occurring during the early stage of HIV-1 infection (i.e., the first few hours to days following HIV exposure) may determine whether the infection can be successfully established. However, the numbers of infected cells and viruses during the early stage are extremely low and stochasticity may play a critical role in dictating the fate of infection. In this paper, we use stochastic models to investigate viral infection and the emergence of drug resistance of HIV-1. The stochastic model is formulated by a continuous-time Markov chain (CTMC), which is derived based on an ordinary differential equation model proposed by Kitayimbwa et al. that includes both forward and backward mutations. An analytic estimate of the probability of the clearance of HIV infection of the CTMC model near the infection-free equilibrium is obtained by a multitype branching process approximation. The analytical predictions are validated by numerical simulations. Unlike the deterministic dynamics where the basic reproduction number $ \mathcal{R}_0 $ serves as a sharp threshold parameter (i.e., the disease dies out if $ \mathcal{R}_0 &lt; 1 $ and persists if $ \mathcal{R}_0 &gt; 1 $), the stochastic models indicate that there is always a positive probability for HIV infection to be eradicated in patients. In the presence of antiretroviral therapy, our results show that the chance of clearance of the infection tends to increase although drug resistance is likely to emerge.</p></abstract>

scholarly journals Genetic Diversity and Drug Resistance Mutations in HIV-1 from Untreated Patients in Niamey, Niger

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Saïdou Mamadou ◽  
Yahayé Hanki ◽  
Amadou Roufaï Ali Maazou ◽  
Balki Aoula ◽  
Sanata Diallo
Keyword(s):  
Drug Resistance ◽  
Genetic Variants ◽  
Care Center ◽  
Rna Extraction ◽  
Resistance Mutation ◽  
Capital City ◽  
Resistance Mutations ◽  
Drug Resistance Mutations ◽  
Drug Naïve ◽  
Hiv 1

The objective of the study was to estimate the prevalence of transmitted resistance to antiretroviral of HIV-1 circulating in Niger. We collected plasmas from 96 drug-naive patients followed up in the main HIV/AIDS Care Center of Niamey, the capital city of Niger. After RNA extraction and retrotranscription to proviral DNA, nested PCR was performed to amplify PR (codons 1–99) and RT (codons 1–240) fragments for sequencing. Sequences were analysed for phylogeny, then for resistance-associated mutations according to IAS-USA and Stanford's lists of mutations. We characterized six HIV-1 genetic variants: CRF02-AG (56.3%), CRF30_0206 (15.6%), subtype G (15.6%), CRF06_cpx (9.4%), CRF11_cpx (2.1%), and CRF01_AE (1%). About 8.3% of HIV strains had at least 1 resistance mutation: 4 strains with at least 1 mutation to NRTI, 5 for NNRTI, and 1 for PI, respectiveley 4.2%, 5.2%, and 1.0%. These preliminary results gave enough information for the need of instauring HIV drug resistance national surveillance.

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