Methods: HIV-infected ART-naïve individuals from Nicaragua were enrolled from 2011 to 2014. Blood samples were collected at Hospital Roberto Calderón in Managua and sent to the Centre for Research in Infectious Diseases in Mexico City, a WHO accredited laboratory, to be processed. HIV pol sequences were obtained by the Sanger method, using an in-house assay. HIV subtyping was performed with REGA Subtyping Tool v2 and RIP 3.0, available on line. TDR was assessed using the WHO TDR surveillance mutation list.
Results: A total of 235 individuals were enrolled in the study. The median age was 32 years (IQR 26-40). The median viral load was 4.8 log RNA copies/mL (IQR 4.2-5.4) and the median CD4+ T cell count was 310 cells/mm3 (IQR 111-462), reflecting earlier median times for presentation to clinical care in Nicaragua compared with other Latin American countries. During the study period the overall TDR prevalence was 12.3% (95% CI 8.4-17.2%). A higher TDR prevalence was found for NRTI (6.0%, 95% CI 3.3-9.8%) and NNRTI (5.5%, 95% CI 3.0-9.3%) compared to PI (1.7%, 95% CI 0.5-4.3%, p<0.05). Individuals using IV drugs were more prone to present TDR (OR 11.8, 95% CI 1.9-73.8, p=0.01) and individuals with TDR had higher CD4+ T cell counts than individuals without TDR (p=0.04). No other demographic or clinical variables were associated with TDR. No significant temporal tendencies were observed in TDR during the study period. The most frequent TDR mutations were M41L for NRTI, K103N for NNRTI, and M46IL for PI. A cluster of viruses with NRTI TDR from men who have sex with men was observed. Subtype B was the most prevalent (98.3%) and non-B subtypes included BD (1.3%) and BF1 (0.4%) viruses.
Conclusion: The global TDR prevalence in Nicaragua –according to the WHO classification- is at the intermediate level. Resistance to NRTI was the most frequent. Although no temporal trends in TDR were observed, further TDR surveillance studies with better representativity are warranted in the country.
D. Tapia-Trejo, None
G. Porras-Cortés, None
C. Quant-Durán, None
S. Moreira-López, None
B. Hernández-Alvarez, None
G. Reyes-Terán, None
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