Pretreatment HIV-drug resistance in Mexico and its impact on the effectiveness of first-line antiretroviral therapy: a nationally representative 2015 WHO survey

Ávila‐Ríos, Santiago; García-Morales, Claudia; Matías-Florentino, Margarita; Romero-Mora, Karla; Tapia-Trejo, Daniela; Quiroz-Morales, Verónica S; Reyes-Gopar, Helena; Ji, Hezhao; Sandstrom, Paul; Casillas-Rodríguez, Jesús; Sierra‐Madero, Juan; León-Juárez, Eddie A; Valenzuela-Lara, Marisol; Magis-Rodríguez, Carlos; Uribe-Zúñiga, Patricia; Reyes‐Terán, Gustavo

doi:10.1016/s2352-3018(16)30119-9

Cited by 94 publications

(94 citation statements)

References 21 publications

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“…We found that the prevalence of TDR to NRTIs, NNRTIs and PIs was 18%, 19% and 4%, respectively. These rates were also consistently higher than previously reported . However, the frequency of dual class resistance was consistent with rates previously reported previously in the general population (5.4–10.3%) .…”

Section: Discussionsupporting

confidence: 92%

“…Other regions of the world with less established use of ART, such as Africa and Asia, report much lower rates of TDR (< 1–8.7%) . The drug class with the highest baseline resistance identified is NRTIs, with reported rates between 1% and 15.8% . Similarly, reported TDR rates range from 1.4 to 10.6% for NNRTIs and 0.7 to 4.5% for PIs .…”

Section: Introductionmentioning

confidence: 99%

“…The drug class with the highest baseline resistance identified is NRTIs, with reported rates between 1% and 15.8% . Similarly, reported TDR rates range from 1.4 to 10.6% for NNRTIs and 0.7 to 4.5% for PIs . Baseline TDR rates for integrase strand transfer inhibitors (INSTIs) are largely unknown, as resistance for this class is not routinely determined at baseline unless there is concern about transmitted INSTI resistance and the provider is considering an INSTI as part of the ART .…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of HIV‐1 transmitted drug resistance in the incarcerated population

et al. 2017

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of HIV‐1 transmitted drug resistance in the incarcerated population

et al. 2017

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“…PDR surveys will be critical given the more recently observed signals of high level HIVDR in several LMIC settings, including Angola (16%), Cuba (22%), Mexico (12%), Papua New Guinea (16%), Botswana (10%) and South Africa (14%) (Afonso et al, 2012; Avila-Rios et al, 2016; Lavu et al, 2015; National Institute for Communicable Diseases, 2016; Perez et al, 2013). In the absence of SGRT-guided therapy, national PDR surveillance among individuals starting ART is critical to predict the activity of available first-line ART and inform the composition of these regimens.…”

Section: Transmitted Drug Resistancementioning

confidence: 99%

HIV-1 drug resistance and resistance testing

Clutter

Jordan

Bertagnolio

et al. 2016

Infection, Genetics and Evolution

256

204

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The global scale-up of antiretroviral (ARV) therapy (ART) has led to dramatic reductions in HIV-1 mortality and incidence. However, HIV drug resistance (HIVDR) poses a potential threat to the long-term success of ART and is emerging as a threat to the elimination of AIDS as a public health problem by 2030. In this review we describe the genetic mechanisms, epidemiology, and management of HIVDR at both individual and population levels across diverse economic and geographic settings. To describe the genetic mechanisms of HIVDR, we review the genetic barriers to resistance for the most commonly used ARVs and describe the extent of cross-resistance between them. To describe the epidemiology of HIVDR, we summarize the prevalence and patterns of transmitted drug resistance (TDR) and acquired drug resistance (ADR) in both high-income and low- and middle-income countries (LMICs). We also review to two categories of HIVDR with important public health relevance: (i) pre-treatment drug resistance (PDR), a World Health Organization-recommended HIVDR surveillance metric and (ii) and pre-exposure prophylaxis (PrEP)-related drug resistance, a type of ADR that can impact clinical outcomes if present at the time of treatment initiation. To summarize the implications of HIVDR for patient management, we review the role of genotypic resistance testing and treatment practices in both high-income and LMIC settings. In high-income countries where drug resistance testing is part of routine care, such an understanding can help clinicians prevent virological failure and accumulation of further HIVDR on an individual level by selecting the most efficacious regimens for their patients. Although there is reduced access to diagnostic testing and to many ARVs in LMIC, understanding the scientific basis and clinical implications of HIVDR is useful in all regions in order to shape appropriate surveillance, inform treatment algorithms, and manage difficult cases.

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“…In the case of Mexico, a national collaborative network was established with clinics in 12 states (27) and further expanded in 2015 to include a total of 17 states (28). The estimated sampling depth of the new diagnoses in each of the participating nations is shown in Supplemental Table S3 and Figure S5.…”

Section: Methodsmentioning

confidence: 99%

Identification of major routes of HIV transmission throughout Mesoamerica

Chaillon

Ávila‐Ríos²,

Wertheim

et al. 2017

Infection, Genetics and Evolution

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Background Migration and travel are major drivers of the spread of infectious diseases. Geographic proximity and a common language facilitate travel and migration in Mesoamerica, which in turn could affect the spread of HIV in the region. Methods 6,092 HIV-1 subtype B partial pol sequences sampled from unique antiretroviral treatment-naive individuals from Mexico (40.7%), Guatemala (24.4%), Honduras (19%), Panama (8.2%), Nicaragua (5.5%), Belize (1.4%), and El Salvador (0.7%) between 2011–2016 were included. Phylogenetic and genetic network analyses were performed to infer putative relationships between HIV sequences. The demographic and geographic associations with clustering were analyzed and viral migration patterns were inferred using the Slatkin-Maddison approach on 100 iterations of random subsets of equal number of sequences per location. Results A total of 1,685/6,088 (27.7%) of sequences linked with at least one other sequence, forming 603 putative transmission clusters (range: 2–89 individuals). Clustering individuals were significantly more likely to be younger (median age 29 vs 33 years, p<0.01) and men-who-have-sex-with-men (40.4% vs 30.3%, p<0.01). Of the 603 clusters, 30 (5%) included sequences from multiple countries with commonly observed linkages between Mexican and Honduran sequences. Eight of the 603 clusters included more than 10 individuals, including two comprised exclusively of Guatemalans (52 and 89 individuals). Phylogenetic and migration analyses suggested that the Central and Southern regions of Mexico along with Belize were major sources of HIV throughout the region (p<0.01) with genetic flow southward from Mexico to the other nations of Mesoamerica. We also found evidence of significant viral migration within Mexico. Conclusion International clusters were infrequent, suggesting moderate migration between HIV epidemics of the different Mesoamerican countries. Nevertheless, we observed important sources of transnational HIV spread in the region, including Southern and Central Mexico and Belize.

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Pretreatment HIV-drug resistance in Mexico and its impact on the effectiveness of first-line antiretroviral therapy: a nationally representative 2015 WHO survey

Cited by 94 publications

References 21 publications

Prevalence of HIV‐1 transmitted drug resistance in the incarcerated population

Prevalence of HIV‐1 transmitted drug resistance in the incarcerated population

HIV-1 drug resistance and resistance testing

Identification of major routes of HIV transmission throughout Mesoamerica

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