Background

1
Trends of integrase inhibitors drug resistance in
treatment-naive patients with HIV-1 subtype C
infection in Brazil Caroline Passaes1, Monick
Guimarães1, Roberta Lorete1, Sabrina Almeida2,
Mariza Morgado1. 1 Oswaldo Cruz Institute, Rio
de Janeiro, Brazil 2 Fundação Estadual de
Produção e Pesquisa em Saúde, Porto Alegre, Brazil

• Background
• The AIDS epidemic in Southern Brazil is mainly
  driven
• by HIV-1 subtype C and BC recombinant forms.
• Integrase recently included as a new therapeutic
  target.
• Resistance related mutations to IN inhibitors
  have been described based on in vitro and in
  clinical studies.
• No study concerning integrase primary mutations
  among subtype C infected individuals has been
  performed until now.

• Objective
• To determine the prevalence of integrase
  inhibitors primary resistance mutations among
  HIV-1 subtype C treatment-naive Brazilian
  patients.

2

• Results
• Samples 93 Brazilian subtype C, collected from
  1998 to 2006.
• Eight mutations previously described as
  conferring in vitro resistance to integrase
  strand transfer inhibitors were detected.

• Mutations related to Raltegravir in vitro
  resistance such as L74I, T97A and I203M were
  observed in a very low frequency.
• All mutations related to Elviteravir or
  Raltegravir resistance in clinical studies were
  not detected in HIV-1 subtype C samples.

3

• Conclusions
• These results highlight the importance of mapping
  the IN genetic diversity, with focus on primary
  resistance mutations occurring as natural
  polymorphisms, principally where non-B subtypes
  are prevalent.
• The absence of major resistance mutations for the
  current IN inhibitors suggests an optimistic
  field for the introduction of these drugs where
  subtype C is prevalent, such as Brazil.

• Acknowledgments
• AIDS 2008 Organizers
• International Scholarship Program
• Members of the Laboratory of AIDS and Molecular
  Epidemiology FIOCRUZ Brazil
• CNPq and FAPERJ grants
• cpassaes_at_ioc.fiocruz.br