Start of HAART with and without genotypic resistance testing in Argentina
L. Marconi1, P. Parenti2, M. Weskamp1, A. Salztman1, J. Palazzi3, S. Lupo1
1UAI , Interamerican University, Internal Medicine, Rosario, Argentina, 2CAICI Institute, Internal Medicine, Rosario, Argentina, 3UAI , Interamerican University, Biochimical, Rosario, Argentina
Background: : The prevalence of primary drug resistance of HAART in HIV patients it has been increasing during the last few years. In spite of it in development countries is difficult to realized a resistant test before start HAART.
Objective: to determine the clinical, virologist and immunological difference after one year of HAART between a group with genotypic resistance test and another without it.
Material and Methods: We realized a retrospective, observational, descriptive study of 104 HIV positive patient from Rosario, Argentina. They were separated in two different group with 52 patient in each; separated into two groups that began HAART with (group A) or without (group B) genotypic resistance test, and observed the clinical, virologist and immunological evolution after one year of antiretroviral therapy.
Results: The middle age in both group was 35 years old, most were male and heterosexual.Group A: the median basal CD4 269 cel (14%), and the VL 151681 copies. The prevalence of primary drug resistance was of 15%, and 1 patient present a multi- class resistant test. After one year: the median CD4 was 618 cel. (28%), and all the patient had an undetectable VL (< 50). Three patient (5%) present a clinical event related to AIDS.Group B: the median basal CD4 194 (13%), and the VL 102116 copies. After a year median CD4 was 512 cel. (24%) and VL 63 copies, 7 (13%) patient present a clinical event related to AIDS and 8 patients showed virological faliure.
Conclusions: the group of patients starting HAART without resistance test showed a higher incidence of virologic failure. Would be desirable that all HIV patients have free access to these tests before starting HAART.
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