Abstract
This is a continuation of our efforts to maintain a record of the evolution of HIV-1 infection in Puerto Rico by monitoring the expression levels of antiretroviral drug-resistance-associated mutations. Samples from 2,500 patients from 2006–2010 were analyzed using the TruGene HIV-1 genotyping kit and the OpenGene DNA sequencing system. Results show that 58.8% of males and 65.3% of females had HIV-1 with resistance to at least one medication. The average number of HIV mutations was 6.0 in males and 6.1 in females. Statistically significant differences between men and women were recorded in the levels of HIV-1 expressed mutations and antiretroviral drug resistance. The most prevalent antiretroviral medication resistance shifted from zalcitabine to nevirapine and efavirenz in the five-year period. M184V and L63P were the dominant mutations for the reverse transcriptase and the protease genes, respectively, but an increase in the incidence of minority mutations was observed.
Highlights
Puerto Rico has one of the highest incidences of HIV infections among the United States and it’s jurisdictions
The results provide a glimpse on the evolving nature of the HIV-1 viral strains circulating in Puerto Rico
More information is needed before an ascending tendency of minority mutations can be established with certainty
Summary
Puerto Rico has one of the highest incidences of HIV infections among the United States and it’s jurisdictions. The official data collected by the Puerto Rico Department of Health indicate that the number of persons living with HIV increased from 39,455 to 43,400 from 2006 to 2010 and that 5,027 new diagnoses were performed during the same period of time (1,460 in 2006, 1,016 in 2007, 975 in 2008, 844 in 2009, and 732 in 2010) [1]. The greatest number of diagnoses of HIV infection occurred among those aged 30 to years, followed by those aged to 49 years. The most common mode of HIV transmission was injection-drug use (40%), followed by male-to-male sexual contact (30%). The most common mode of HIV transmission was high-risk heterosexual contact (73%), followed by injection-drug use (27%). The rate of diagnosis of HIV infection in Puerto Rico in 2006 was 45.0 per 100,000 population, twice the estimated US rate (22.8) and 1.5 times the estimated rate for Hispanics in the United States (29.4).
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