Resistance to antiretroviral drugs in patients with human immunodeficiency virus in Mario Catarino Rivas National Hospital

Abstract

First-line antiretroviral therapy used in the country for several years, which con- sists of a non-nucleoside reverse transcriptase inhibitor with two nucleoside reverse transcrip- tase inhibitors, is associated with therapeutic failure and resistance to it has been reported. Objective: To know the resistance to first-line antiretroviral therapy in patients treated for Human Immunodeficiency Virus at the Mario Catarino Rivas National Hospital from october 2016 to 2017. Patients and methods: Observational, descriptive research; retrospective, cross-sectional cohort type. Population of 313 patients who underwent genotype testing, of which 291 patients were taken as a sample distributed by groups: without previous exposure to antiretrovirals, pediatric, with 12 months of treatment and 48 or more months of treatment who were performed genotype test. Results: There was amplification in 52% (152) of the patients, of which 56% (85) presented resistance to antiretroviral treatment, with a prevalence of resistance to nucleoside analog reverse transcriptase inhibitors of 75% (64). non nucleoside reverse transcriptase inhibitors (NRTIs) with 89% (76) and protease inhibitors 15% (13). A prevalence of primary resistance of 19% was found in newly diagnosed patients. Conclusion: A change to the first line of antiretroviral therapy is recommended since resistance mutations to NNRTI were identified in 91% in patients with a recent diagnosis and without exposure to ARVs. The WHO recommends withdrawing NRTIs as the first line therapy and including drugs with a better genetic barrier, when resistance levels for NRTIs are> 10%.