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Comprehensive HIV Care and Support in São Paulo State

Explore the free access to HIV clinical services, ARV therapy, laboratories, and latest research findings in São Paulo State. Learn about indels frequency and impact on resistance, urging for improved bioinformatics tools.

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Comprehensive HIV Care and Support in São Paulo State

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  1. The Brazilian Health System guarantees to HIV patients free access to: • HIV Clinical Center Test / VTC (Voluntary Counseling and Test Center) – 645 units • ARV therapy – 19 ARV drugs • Laboratories • CD4/CD8 – 90 labs. • Viral load – 80 labs. • Genotyping test – 24 labs. São Paulo State Population: 41.384.039 inhab. People living with HIV/Aids: 180.000 pts. (est.) 1703 seqs from pts ARV failure, (2004 - 2009). 33 sequences with insertion or deletion in pol gene Submission Geno2Pheno Abstract # THDPA202 Stanford

  2. Indels frequency – 1,9%. • RT Ins – diverg. 87,5% Note: 69 RT insertion increases the resistance on NRTIs, when with 1 or more TAM, (Miller, 2004). • RT Del – diverg. 25% Note:67 RT deletion increases the resistance on NRTIs 69 RT deletion has unknown impact from our undestanding. (Imamichi, 2000). • PR Ins – diverg. 55,5% Note:There is no consensus about impact on resistance to PIs at PR insertions, (Chen, 2008). Abstract # THDPA202

  3. Conclusions • Frequency of indels is similar to the described in literature, 1,9%; • The resistance algorithms are useful for most sequences; • Some sequences have discrepant results between the algorithms; • Some discrepancies in codon location of indels position may change the resistance profile of some ARV; • These discrepancies suggest that it would be important to have extra care and a critical view when using these tools for unusual samples; • Better interaction among laboratories and bioinformatics researches is recommended to improve these tools. Abstract # THDPA202

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