RESUMO
OBJECTIVE: Our objective was to estimate primary resistance in an urban setting in a developing country with a long history of antiretroviral delivery and high coverage levels. DESIGN: We carried out a resistance surveillance study according to WHO HIV-Resistance Guidelines. METHODS: Blood samples were collected from 323 drug-naive HIV-1 infected individuals diagnosed at two HIV voluntary counselling and testing centers in Buenos Aires. Viral-load, CD4 cell counts and detuned assays were performed on all samples. The pol gene was sequenced and the resistance profile determined. Phylogenetic analysis was performed by neighbor-joining trees and bootscanning analysis. RESULTS: We found that 12 (4.2%) of the 284 samples sequenced harbored primary resistance mutations, of which K103N, M41L and V108I were most prevalent. Phylogenetic analysis revealed evidence for the transmission of the K103N mutation among the drug-naive population. The proportion of recent infections identified by the detuned assay was 10.1%. CONCLUSIONS: Levels of primary resistance in Buenos Aires are still low, despite a long history of ARV delivery and high coverage levels.
Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/epidemiologia , HIV-1/efeitos dos fármacos , Adulto , Argentina/epidemiologia , Países em Desenvolvimento , Farmacorresistência Viral/genética , Feminino , Genes Virais/genética , Infecções por HIV/tratamento farmacológico , Infecções por HIV/genética , HIV-1/genética , Humanos , Masculino , Mutação , Vigilância da População/métodos , Inibidores da Transcriptase Reversa/uso terapêutico , Medição de Risco/métodos , Saúde da População UrbanaRESUMO
Desde la pandemia de Influenza del año 2009, se realizaron campañas de vacunación, aumentaron las consultas médicas y el uso de medicación. Los datos recolectados durante las últimas temporadas nos permitieron describir incidencia de casos de influenza, comparar la incidencia de tipos y subtipos, y la frecuencia de vacunación. Para ello se realizó un estudio prospectivo, observacional de cohorte, sobre la población de pacientes que consultaron al Hospital J. M. Ramos Mejía desde octubre/2010 a septiembre/2013. Participaron 336 pacientes de los cuales 147 tuvieron resultado positivo para Influenza. La incidencia de casos de Influenza fue 43,7% sobre los pacientes con síntomas gri-pales durante el periodo evaluado. Se observó que el odds de presen-tar infección por influenza fue 3,8 veces de los pacientes no vacunados que los que recibieron la vacuna antigripal. Estos resultados permitie-ron observar una variación estacional de los subtipos virales de Influen-za, frecuencia de vacunación y complicaciones de nuestra población
Since the 2009 pandemic Influenza, vaccination campaigns were conducted, and medical visits and medication use increased. The data collected during recent flu seasons allowed us to describe Influenza type and subtype incidence, and to compare the incidence and frequency of vaccination. A prospective, observational cohort study was conducted of the patient population attended in the J. M. Ramos Mejia Hospital from October / 2010 to September / 2013. It involved 336 patients of which 147 were positive for influenza. The incidence of influenza was of 43.7% over the symptomatic subjects during the study period. It was observed that the odds of presenting influenza infection was 3.8 times in unvaccinated patients than those who received flu vaccine. These results show a seasonal variation of influenza viral subtypes, the vaccination frequency and the medical complications