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  • ISSN: 2374-0094
    Early Online
    Volume 7, Issue 1
    Research Article
    Perez L*, Machado LY, Pintos Y, Diaz HM, Kouri V, Aragones C, Correa C, Aleman Y, Silva E, Blanco de Armas M, Perez LJ, Mune M, Dubed M, Soto Y, Ruiz N, Limia CM, Nibot C,Valdes N, Ortega LM, Romay D, Campos Y, Rivero CB, and Campos J
    Background: High levels of acquired drug resistance have been reported in Cuban HIV-1 infected patients. The aim of this study is to determine the levels of primary HIV drug resistance in newly diagnosed Cuban´s patients.
    Material and methods: Demographic, clinical and laboratory data were collected from 225 newly diagnosed HIV-1 patients from Cuba between April 2013 and April 2014. Sequences of 187 patients were analyzed. The HIV-1 pol gene was sequenced using Sanger sequencing. Drug resistance was interpreted according to the WHO surveillance drug-resistance mutations list, 2009. HIV-1 subtyping was performed using the Rega subtyping tool version 3.
    Results: The mean age at sampling time was 33.5 years, 80.7% of the patients were men and the major transmission route was MSM (80.1%). The 27.2% of patients had HIV-1 chronic infection and 72.7% recent infection. The median viral load value was 60,300 RNA copies/mL (16,900 - 133,000), and median CD4+ count value was 359 cells/mm3 (263-558). In the 17.6% (33/187), of the studied viruses, transmitted resistance mutations were detected. Simple non-nucleoside mutants were the most common (1.1%), followed by double class resistance against to nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors (8.0%) and single mutants to the protease inhibitors (2.1%). From the 33 patients with transmitted drug resistances mutations, 22 (66.6%) were MSM, 26 (78.8%), were diagnosed with a recent HIV-1 infection, 13 (39.4%) were from Havana
    Conclusions: This study highlights the need of further studies in order to elucidate the factors that influencing the high levels of resistance in newly diagnosed population, in order to take actions toward the possible causes. It also reinforces the need for drug resistance testing in patients that start therapy. It was shown that first-line therapy may not be effective, so in 2016 it is replaced by Atripla.
    Rommie Navylia Abele*, Peter Anderson, and Frederick Schulze
    Since the introduction of antiretroviral therapy, the survival rate of infected HIV patients has been on the rise with a predicted increase by 2030. The longer a person lives with the virus, the more prone to HIV-associated chronic diseases he or she becomes, but it is not clear whether these diseases are solely from aging with the virus or from long-term use of antiretroviral therapy. Scientists, however, have failed to address the challenges of aging and living with HIV. The purpose of this study, driven by both social constructivism as well as the advocacy worldview, was to explore the lived experiences of participants older than 50, living with HIV for at least 20 years, to gain an understanding of how long-term use of antiretroviral therapy relates to the onset of comorbidities, which would lead to a new understanding of the challenges they face. The methodology of the study was a phenomenological approach; data were collected through participants’ responses during recorded telephone interviews before being transcribed and analyzed using Nvivo software. Findings indicated that these participants live in daily survivorship filled with constant struggle between a series of comorbidities that develop overtime. Additionally, their journey is not only coupled with unmet needs of today but also with uncertainties of tomorrow. The findings can improve the current social conditions of the population in question by providing information to healthcare professionals so they can better address their needs, thus improving and maintaining their health.
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