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Antiretroviral Drug Resistance Surveillance among Treatment-Naive Human Immunodeficiency Virus Type 1-Infected Individuals in Angola: Evidence for Low Level of Transmitted Drug Resistance
Antimicrobial Agents and Chemotherapy, 06/29/09

Bártolo I et al. - Numerous new polymorphisms were identified in the reverse transcriptase and protease. Two unrelated patients harbored nucleoside reverse transcriptase inhibitor- and nonnucleoside reverse transcriptase inhibitor-resistant viruses. Continued surveillance of drug resistance is required for maximization of ART efficacy in Angola.

Exclusive Author Commentary
Nuno Taveira, 06/30/09

Transmission of drug resistant HIV-1 strains may compromise the efficacy of antiretroviral therapy (ART) especially in developing countries with limited access to second-line regimens. We found that primary resistance to ART was residual (<5%) in Luanda, Angola, in 2001. Of note, however, two untreated patients were infected with drug resistant variants even though access to ART was still not generalized in Angola in 2001. In recent years ART has been made available to a greater number of patients in Angola. To avoid further transmission of drug resistant strains and to be able to offer the most successful therapeutic regimens in Angola, it is important to implement drug resistance surveillance systems in Angola and perform regular studies of drug resistance in treated and untreated patients. We are doing a follow-up study of primary resistance to ART in untreated HIV-1 patients from Luanda with samples collected in 2008. Preliminary results indicate that in 2008 primary resistance to ART was still residual (1 case in 19 patients studied so far). Pending the analysis of more patients, these results suggest that transmission of drug resistant HIV-1 variants will not be a major problem in Angola.

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