{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T21:28:46Z","timestamp":1785101326588,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T00:00:00Z","timestamp":1520208000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006506","name":"Minist\u00e9rio da Sa\u00fade","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006506","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In Brazil, more than 487,450 individuals are currently undergoing antiretroviral treatment. In order to monitor the transmission of drug\u2010resistant strains and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> subtype distribution in the country, this work aimed to estimate its prevalence and to characterize the nationwide pretreatment drug resistance in individuals recently diagnosed with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> between 2013 and 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> threshold survey methodology (<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">THS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> WHO<\/jats:styled-content>) targeting antiretroviral\u2010naive individuals with recent <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> diagnosis was utilized, and subjects were selected from 51 highly populated cities in all five Brazilian macroregions. The <jats:styled-content style=\"fixed-case\">HIV <\/jats:styled-content><jats:italic>pol<\/jats:italic> genotypic test was performed by genomic sequencing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analysed samples from 1568 antiretroviral\u2010naive individuals recently diagnosed with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>, and the overall transmitted drug resistance (<jats:styled-content style=\"fixed-case\">TDR<\/jats:styled-content>) prevalence was 9.5% (150 sequences). The regional prevalence of resistance according to Brazilian geographical regions was 9.4% in the northeast, 11.2% in the southeast, 6.8% in the central region, 10.2% in the north and 8.8% in the south. The inhibitor\u2010specific <jats:styled-content style=\"fixed-case\">TDR<\/jats:styled-content> prevalence was 3.6% for nucleoside reverse transcriptase inhibitors (<jats:styled-content style=\"fixed-case\">NRTI<\/jats:styled-content>s), 5.8% for non\u2010nucleoside reverse transcriptase inhibitors (<jats:styled-content style=\"fixed-case\">NNRTI<\/jats:styled-content>s) and 1.6% for protease inhibitors (<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>s); 1.0% of individuals presented resistance to more than one class of inhibitors. Overall, subtype B was more prevalent in every region except for the southern, where subtype C prevails.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>To the best of our knowledge, this is the first <jats:styled-content style=\"fixed-case\">TDR<\/jats:styled-content> study conducted in Brazil with nationwide representative sampling. The <jats:styled-content style=\"fixed-case\">TDR<\/jats:styled-content> prevalence revealed a moderate rate in the five Brazilian geographical regions, although some cities presented higher <jats:styled-content style=\"fixed-case\">TDR<\/jats:styled-content> prevalence rates, reaching 14% in S\u00e3o Paulo, for example. These results further illustrate the importance of surveillance studies for designing future strategies in primary antiretroviral therapy, aiming to mitigate <jats:styled-content style=\"fixed-case\">TDR<\/jats:styled-content>, as well as for predicting future trends in other regions of the globe where mass antiretroviral (<jats:styled-content style=\"fixed-case\">ARV<\/jats:styled-content>) treatment was implemented.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25032","type":"journal-article","created":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T09:18:42Z","timestamp":1520241522000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Brazilian network for <scp>HIV<\/scp> Drug Resistance Surveillance (<scp>HIV<\/scp>\u2010BresNet): a survey of treatment\u2010naive individuals"],"prefix":"10.1002","volume":"21","author":[{"given":"Monica B","family":"Arruda","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Virologia Molecular Departamento de Gen\u00e9tica\u2010IB Universidade Federal do Rio de Janeiro Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00eddia T","family":"Boullosa","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Virologia Molecular Departamento de Gen\u00e9tica\u2010IB Universidade Federal do Rio de Janeiro Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia C","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Virologia Molecular Departamento de Gen\u00e9tica\u2010IB Universidade Federal do Rio de Janeiro Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina M","family":"da Costa","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o de Medicina Tropical do Amazonas Manaus AM 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