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High prevalence of primary antiretroviral resistance among HIV-1-infected adults and children in Bahia, a northeast state of Brazil.

The introduction of highly active antiretroviral therapy (HAART) for treatment of AIDS patients significantly decreases AIDS-associated morbidity and mortality. Resistance to antiretroviral (ARV) drugs may arise during treatment however and is considered the main cause of therapy failure. Although the major reason for the onset of drug resistance is poor adherence to treatment acquisition of resistant strains of HIV also contributes to therapeutic failure. Brazil was the first country to provide free-of-cost ARV drugs for HIV therapy. This raised concerns about the selection and dissemination of drug-resistant HIV because of poor adherence and the extensive exposure to ARV drugs. Nevertheless the Brazilian AIDS program is considered a success and the available data show a low rate of HIV-1 drug resistance among drug-naive patients. To determine the prevalence of resistance mutations among recently diagnosed HIV-infected drug-naive patients we evaluated plasma or HIV-1 RNA samples stored at the Retrovirology Laboratory of the Federal University of Bahia Hospital in Salvador Brazil. The samples were obtained from the plasma of recently diagnosed patients from our AIDS clinics and from local blood banks after the year 2000. The institutional Ethics Review Board approved the study. (excerpt)