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HIV genotyping test and of salvage therapies in the state of São Paulo

Abstract

The increasingly complexity of antiretroviral therapies and laboratory monitoring tools to support clinical decision reflect the advances in the combat of AIDS but also represent a defiance to the sustainability of the national AIDS program albeit recommendation of initial regimen and suggestions for salvage therapy are available for some situations, a suggestion of clinical conduct is provided by reference physician based in HIV genotyping. The test identifies resistance associated mutations that emerge due to therapy. Some studies provide support for a benefit of the test in some situations, but its impact in real world clinical practice is still not established. Studies that can evaluate salvage therapy algorithms applicable to most common situations, and the identification of factors that lead to failure of salvage regimes are at limited or non-existent. The study proposed to document the major variables and outcomes associated to the impact of the test in clinical practice and to evaluate salvage therapy algorithms that may be useful to subsidize clinical decision where the test is not available. The mutation pattern, therapeutic history will be analyzed in conjunction to viral load, TCD counts, adhesion and subsequent clinical events after the initiation of salvage therapy. Among cases with virological failure that shows evidence of transient viral suppression factors that may be associated to regimen failure will be evaluated, including behavioral characteristics, adhesion, plasma drug levels, emergence of new mutations and super infection. A subset of cases at higher risk for primary resistance initiating therapy will also be evaluated. The objective is to established a collaborative, structured research initiative at Units of the National Health System that are part of the Genotype network, an effort that can be instrumental to resistance surveillance and to the evaluation of salvage therapy in Sao Paulo State. (AU), En

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Scientific publications (6)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
SILVA LOPEZ-LOPES, GISELLE IBETTE; LANCA, ANDRE MINHOTO; DE PAULA FERREIRA, JOAO LEANDRO; SOUZA, LUCIANA OLIVEIRA; DE MACEDO BRIGIDO, LUIS FERNANDO. Discrepancies of HIV-1 Reverse Transcriptase Resistance Interpretation of Insertions and Deletions between Two Genotypic Algorithms. Intervirology, v. 56, n. 4, p. 217-223, 2013. Web of Science Citations: 1.
ALMEIDA, FLAVIA JACQUELINE; RODRIGUES, ROSANGELA; ZAPAROLI, MAYRA SIMIONI; BEREZIN, EITAN NAAMAN; PALAZZI SAFADI, MARCO AURELIO; DE PAULA FERREIRA, JOAO LEANDRO; LANCA, ANDRE MINHOTO; DE MACEDO BRIGIDO, LUIS FERNANDO. Prevalence of Transmitted HIV-1 Drug Resistance Mutations in Children and Adolescents in Sao Paulo, Brazil. PEDIATRIC INFECTIOUS DISEASE JOURNAL, v. 31, n. 12, p. E255-E257, DEC 2012. Web of Science Citations: 5.
CAVALCANTI, JAQUELINE SOUZA; LANCA, ANDRE MINHOTO; DE PAULA FERREIRA, JOAO LEANDRO; DA EIRA, MARGARETH; DE SOUZA DANTAS, DANIEL SOARES; DE MACEDO BRIGIDO, LUIS FERNANDO. In-vivo selection of the mutation F121Y in a patient failing raltegravir containing salvage regimen. Antiviral Research, v. 95, n. 1, p. 9-11, JUL 2012. Web of Science Citations: 6.
LANCA, ANDRE MINHOTO; BAIMA COLLARES, JEOVA KENY; DE PAULA FERREIRA, JOAO LEANDRO; LIMA, DANIELLE MALTA; DE MACEDO BRIGIDO, LUIS FERNANDO; RODRIGUES, ROSANGELA; LOPES DA FONSECA, BENEDITO ANTONIO. HIV-1 tropism and CD4 T lymphocyte recovery in a prospective cohort of patients initiating HAART in Ribeirao Preto, Brazil. Memórias do Instituto Oswaldo Cruz, v. 107, n. 1, p. 96-101, FEB 2012. Web of Science Citations: 6.
BRIGIDO, L. F. M.; FERREIRA, J. L. P.; ALMEIDA, V. C.; ROCHA, S. Q.; RAGAZZO, T. G.; ESTEVAM, D. L.; RODRIGUES, R.; WORKGRP, SAO PAULO HIV SALVAGE. Southern Brazil HIV Type 1 C Expansion into the State of Sao Paulo, Brazil. AIDS Research and Human Retroviruses, v. 27, n. 3, p. 339-344, MAR 2011. Web of Science Citations: 21.
RODRIGUES, ROSANGELA; MANENTI, SANDRA; TORRES ROMAO, PEDRO ROOSEVELT; DE PAULA FERREIRA, JOAO LEANDRO; GERVASIO BATISTA, JOAO PAULO; ALMEIDA CARVALHO SIQUEIRA, ANTONIO FLAVIO; DE MACEDO BRIGIDO, LUIS FERNANDO. Young Pregnant Women Living with HIV/AIDS in Criciuma, Southern Brazil, Are Infected Almost Exclusively with HIV Type 1 Clade C. AIDS Research and Human Retroviruses, v. 26, n. 3, p. 351-357, MAR 2010. Web of Science Citations: 12.

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