RESUMEN
OBJECTIVES: To assess the prevalence and patterns of pre-treatment HIV drug resistance (PDR) and HIV-1 subtype in infants from Argentina with exposure to different antiretroviral drugs (ARVs) for the prevention of mother-to-child transmission (PMTCT). PATIENTS AND METHODS: HIV-1 genotyping was performed in 115 infants (median age = 2.3 months) born between 2007 and 2014 to screen for drug resistance mutations (DRMs) before starting first-line ART. HIV-1 subtype was characterized by phylogenetic and recombination analysis. RESULTS: Overall, DRMs were found in 34 of 115 infants (PDR level 30% to any ARV, 3.5% to PIs, 12% to NRTIs and 22% to NNRTIs). Of the 115 infants, 22 (19.1%) were ARV-unexposed. Another 93 were ARV-exposed: 28 (24.3%) to short-course zidovudine monotherapy ARV prophylaxis; 25 (21.7%) to nevirapine-based ARV prophylaxis; 12 (10.4%) to perinatal infant zidovudine prophylaxis + maternal combination ART with NNRTIs; and 28 (24.3%) to perinatal infant zidovudine prophylaxis+maternal combination ART with PIs. Transmitted drug resistance among ARV-unexposed infants was 32% (5% to PIs, 9% to NRTIs and 18% to NNRTIs). ART-exposed infants showed multi-class ARV resistance. Importantly, vertical transmission of a triple-class-resistant virus was confirmed in one case. Patterns of DRMs predicted high-level resistance to NNRTIs in a similar and high proportion (>50%) of infants with at least one DRM independently of ARV exposure. BF recombinants were found in 74%, subtype B in 20%, subtype C in 3% and novel AG and AB recombinants in 3%. CONCLUSIONS: PDR in HIV-1-infected children from Argentina is among the highest reported, jeopardizing successful lifelong suppressive ART as well as the efficacy of current PMTCT regimens.
Asunto(s)
Farmacorresistencia Viral , Infecciones por VIH/prevención & control , Infecciones por VIH/virología , VIH-1/genética , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Fármacos Anti-VIH/farmacología , Fármacos Anti-VIH/uso terapéutico , Argentina/epidemiología , Femenino , Genotipo , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , VIH-1/efectos de los fármacos , Humanos , Lactante , Masculino , Mutación , Prevalencia , Vigilancia en Salud Pública , Factores de Riesgo , Productos del Gen pol del Virus de la Inmunodeficiencia HumanaRESUMEN
Introducción: se ha sugerido que la lactancia materna juega un rol importante en la prevención de obesidad infantil si se da de forma exclusiva durante los primeros 6 meses de vida. El motivo principal de este estudio fue el de investigar esta posible relación en una población de niños de 3 a 5 años de edad. Métodos: por medio de encuestas se determinó el tipo de alimentación durante los primeros 6 meses de vida de 150 niños de 3 a 5 años de edad. Los niños fueron pesados, medidos y se clasificaron según el percentil correspondiente a su Indice de Masa Corporal (IMC). Se analizaron los datos utilizando ANOVA...