Diversity and prevalence of antiretroviral genotypic resistance mutations among HIV-1-infected children

Almeida, Flávia Jacqueline; Berezin, Eitan Naaman; Rodrigues, Rosangela; Sáfadi, Marco Aurélio Palazzi; Arnoni, Mariana Volpe; Oliveira, Cristina Mendes de; Brígido, Luis Fernando de Macedo

doi:10.2223/jped.1877

Cited by 25 publications

(11 citation statements)

References 27 publications

(23 reference statements)

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“…Our results on genotype resistance mutations are consistent with previous studies with similar subjects indicating that prevalence of major mutations conferring ART resistance in viral DNA/RNA of such chronically infected groups is common (20/38, 52.6%) [34]. In patients with available sequences from the Pro and/or RT, the mutations found in PBMCs were generally also found in the plasma, although some of the patients showed few differences between the two compartments, while in one patient (010BR_IMT_011) the 69 insertion in the protease region was found in PBMC, but not in plasma.…”

Section: Discussionsupporting

confidence: 92%

“…The results presented confirmed that subtype B is still the main HIV-1 variant and concordant with data from other studies on adult and children populations from Brazil [24], [33], [34], [35]. The most remarkable observations in this study are that at least 38.1% of the 42 patients with proviral DNA sequences are infected with HIV-1 BF1 recombinant variants, which is relatively much higher if compared to earlier studies on children and adolescent patients in Brazil [33], [34], [35], [36], [37], [38]. This difference is not surprising, because small fragments from different regions of HIV genomes were characterized in the previous studies while we used larger overlapped fragments to sequence the full-length genome, which undoubtedly provides efficient discrimination of HIV subtypes and the recombinant forms.…”

Section: Discussionsupporting

confidence: 91%

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Variability of HIV-1 Genomes among Children and Adolescents from São Paulo, Brazil

et al. 2013

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BackgroundGenetic variability is a major feature of the human immunodeficiency virus type 1 (HIV-1) and considered the key factor to frustrating efforts to halt the virus epidemic. In this study, we aimed to investigate the genetic variability of HIV-1 strains among children and adolescents born from 1992 to 2009 in the state of Sao Paulo, Brazil.MethodologyPlasma and peripheral blood mononuclear cells (PBMC) were collected from 51 HIV-1-positive children and adolescents on ART followed between September 1992 and July 2009. After extraction, the genetic materials were used in a polymerase chain reaction (PCR) to amplify the viral near full length genomes (NFLGs) from 5 overlapped fragments. NFLGs and partial amplicons were directly sequenced and data were phylogenetically inferred.ResultsOf the 51 samples studied, the NFLGs and partial fragments of HIV-1 from 42 PBMCs and 25 plasma were successfully subtyped. Results based on proviral DNA revealed that 22 (52.4%) patients were infected with subtype B, 16 (38.1%) were infected with BF1 mosaic variants and 4 (9.5%) were infected with sub-subtype F1. All the BF1 recombinants were unique and distinct from any previously identified unique or circulating recombinant forms in South America. Evidence of dual infections was detected in 3 patients coinfected with the same or distinct HIV-1 subtypes. Ten of the 31 (32.2%) and 12 of the 21 (57.1%) subjects with recovered proviral and plasma, respectively, protease sequences were infected with major mutants resistant to protease inhibitors. The V3 sequences of 14 patients with available sequences from PBMC/or plasma were predicted to be R5-tropic virus except for two patients who harbored an X4 strain.ConclusionsThe high proportion of HIV-1 BF1 recombinant, coinfection rate and vertical transmission in Brazil merits urgent attention and effective measures to reduce the transmission of HIV among spouses and sex partners.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Variability of HIV-1 Genomes among Children and Adolescents from São Paulo, Brazil

et al. 2013

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“…The population we studied is likely representative of the pediatric HIV population at these sites with expertise in pediatric HIV and availability of ARVs, but we cannot comment on how representative our population is of the whole region. In comparison to other studies, this rate of primary drug resistance is lower than that reported in children in Northeast Brazil [9] and higher than the 0% rate reported in 24 children in Sao Paulo, Brazil [13] (although reverse transcriptase mutation K219N was seen in one subject in the latter study, which, by our definition [12], yields a rate of 4.2%). Studies from the United States and Argentina have shown higher rates in HIV-infected infants [6, 7, 10].…”

Section: Discussioncontrasting

confidence: 73%

HIV Drug Resistance-Associated Mutations in Antiretroviral Naïve HIV-1-Infected Latin American Children

Rodríguez-Díaz

et al. 2010

Advances in Virology

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Our goal was to describe the presence of HIV drug resistance among HIV-1-infected, antiretroviral (ARV) naïve children and adolescents in Latin America and to examine resistance in these children in relation to drug exposure in the mother. Genotyping was performed on plasma samples obtained at baseline from HIV-1-infected participants in a prospective cohort study in Brazil, Argentina, and Mexico (NISDI Pediatric Study). Of 713 HIV-infected children enrolled, 69 were ARV naïve and eligible for the analysis. At enrollment, mean age was 7.3 years; 81.2% were infected with HIV perinatally. Drug resistance mutations (DRMs) were detected in 6 (8.7%; 95% confidence interval 3.1–18.2%) ARV-naïve subjects; none of the mothers of these 6 received ARVs during their pregnancies and none of the children received ARV prophylaxis. Reverse transcriptase mutations K70R and K70E were detected in 3 and 2 subjects, respectively; protease mutation I50 V was detected in 1 subject. Three of the 6 children with DRMs initiated ARV therapy during followup, with a good response in 2. The overall rate of primary drug resistance in this pediatric HIV-infected population was low, and no subjects had more than 1 DRM. Mutations associated with resistance to nucleoside reverse transcriptase inhibitors were the most prevalent.

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“…The proposed methodology is described as low-cost and easy to apply and permits the identification of problems in routine service provision in addition to monitoring compliance with Ministry of Health recommendations for pre-natal care. Almeida et al 49 evaluated genotyping and subtyping in antiretroviral-naïve and experienced children and used this information to analyze drug resistance profiles, concluding that rates of primary resistance in antiretroviral-naïve children are low, whereas they are high in children who fail antiretroviral treatment, which is compatible with its use in these patients. Olajubu et al 50 described the seroprevalence of HIV among blood donors, antenatal women, and other patients in a tertiary hospital in Nigeria and found that though there is a high prevalence rate among in- and out-patients, many of these patients were screened based on manifestations of clinical symptoms.…”

Section: Methodsmentioning

confidence: 99%

Metabolic and infectious pathologies in Brazilian medical literature: a review

Rocha-e-Silva¹

2010

Clinics

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OBJECTIVE: This review of original reports on metabolic and infectious diseases that were recently published in Brazilian journals is designed to inform the readership of CLINICS about their content.METHODS: I conducted a search in PubMed for original research articles (clinical or basic research) recently published (2008)(2009) by Brazilian medical and biological periodicals. Papers on metabolic pathologies were retrieved by searching for appropriate keywords such as metabolic syndrome and obesity. Papers on infectious disease were obtained by entering 15 different keywords for the most commonly occurring pathologies. Review articles, editorials, letters to the editor, and case reports were manually excluded. Selected titles were then categorized into appropriate sub-categories. RESULTS:This search produced a total of 123 articles, which filtered down to 72 articles after eliminating editorials, review articles, letters to the Editor and case reports.

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Diversity and prevalence of antiretroviral genotypic resistance mutations among HIV-1-infected children

Cited by 25 publications

References 27 publications

Variability of HIV-1 Genomes among Children and Adolescents from São Paulo, Brazil

Variability of HIV-1 Genomes among Children and Adolescents from São Paulo, Brazil

HIV Drug Resistance-Associated Mutations in Antiretroviral Naïve HIV-1-Infected Latin American Children

Metabolic and infectious pathologies in Brazilian medical literature: a review

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