Antiretroviral resistance in individuals presenting therapeutic failure and subtypes of the human immunodeficiency virus type 1 in the Northeast Region of Brazil
“…The only sequence in the CRF12_BF clade, which was found in a Brazilian man, has the same lineage as the Brazilian sequences. 48,49 The only F1 subtype was detected in a Romanian man, which is consistent with the high percentage of this subtype in this country. 50,51 In summary, the existence of independent monophyletic clades implies the presence of separate transmission networks for non-B subtypes within the population analyzed.…”
An increase in the circulation of HIV-1 non-B subtypes has been observed in recent years in Western European countries. Due to the lack of data on the circulation of HIV-1 non-B subtypes among European HIV-1-infected men who have sex with men (MSM), a biomolecular study was conducted in Rome, Italy. HIV-1 partial pol gene sequences from 111 MSM individuals (76 drug naive and 35 drug experienced) were collected during the years [2004][2005][2006]. All these sequences were analyzed using the REGA HIV-1 Subtyping Tool, and aligned using CLUSTAL X followed by manual editing using the Bioedit software. A BLAST search for non-B subtype sequences was also performed. Twenty-six (23.4%) MSM were not Italians. Eight individuals (7.2%) were diag- The CRFs were more prevalent (8.1%) than pure subtypes (5.4%), which were distributed as follows: subtype C (2.6%), subtype A1 (1.7%), and subtype F1 (0.9%). Major mutations conferring resistance to antiretroviral drugs (ARV) were not found among HIV-1 non-B subtype drugnaive patients but were found in two ARV-experienced individuals. The data show that viral diversity is likely increasing in a population group that had been previously characterized by the circulation of HIV-1 subtype B.
“…The only sequence in the CRF12_BF clade, which was found in a Brazilian man, has the same lineage as the Brazilian sequences. 48,49 The only F1 subtype was detected in a Romanian man, which is consistent with the high percentage of this subtype in this country. 50,51 In summary, the existence of independent monophyletic clades implies the presence of separate transmission networks for non-B subtypes within the population analyzed.…”
An increase in the circulation of HIV-1 non-B subtypes has been observed in recent years in Western European countries. Due to the lack of data on the circulation of HIV-1 non-B subtypes among European HIV-1-infected men who have sex with men (MSM), a biomolecular study was conducted in Rome, Italy. HIV-1 partial pol gene sequences from 111 MSM individuals (76 drug naive and 35 drug experienced) were collected during the years [2004][2005][2006]. All these sequences were analyzed using the REGA HIV-1 Subtyping Tool, and aligned using CLUSTAL X followed by manual editing using the Bioedit software. A BLAST search for non-B subtype sequences was also performed. Twenty-six (23.4%) MSM were not Italians. Eight individuals (7.2%) were diag- The CRFs were more prevalent (8.1%) than pure subtypes (5.4%), which were distributed as follows: subtype C (2.6%), subtype A1 (1.7%), and subtype F1 (0.9%). Major mutations conferring resistance to antiretroviral drugs (ARV) were not found among HIV-1 non-B subtype drugnaive patients but were found in two ARV-experienced individuals. The data show that viral diversity is likely increasing in a population group that had been previously characterized by the circulation of HIV-1 subtype B.
“…Most of other Brazilian studies reported NNRTI prevalence of mutations of 30 to 55.4%. 21,23,25,26 In Santos, the overall NNRTI prevalence was not explicit, but K103N occurred in 52% of patients, whereas in these data from Paraná it was 43.4%. 27 At Brazilian Northeast region, the specifi c mutations were even higher, with 62% substitutions in codon 103, 38.7% in codon 190 and 181 in codon 29.2%.…”
Section: Discussionmentioning
confidence: 59%
“…20 The most prevalent mutation occurred at codon 184 (68.31%), as reported in São Paulo (64%), 24 Rio de Janeiro (67%), 23 and Northeast Brazil (66%). 25 In Santos, from 2006, this mutation was even more prevalent (88%). 27 In Paraná, when samples from 2006 were analysed, the prevalence of M184V was of 75%, consistent with the signifi cant increase of lamivudine exposure.…”
Section: Discussionmentioning
confidence: 99%
“…21,23,25,26 Only one national study showed even higher prevalence of wildtype virus (15.3%). 20 The most prevalent mutation occurred at codon 184 (68.31%), as reported in São Paulo (64%), 24 Rio de Janeiro (67%), 23 and Northeast Brazil (66%).…”
Section: Discussionmentioning
confidence: 99%
“…20 From 2004 to 2007, many other authors showed data from the prevalence of antiretroviral resistance in adults from Bahia, São Paulo, Rio de Janeiro, Federal District and North Eastern states. [21][22][23][24][25][26][27] The aim of this study is to analyze the genotypic profile of patients tested for resistance in the Brazilian state of Paraná, in order to determine the frequency of RT and PR mutations among patients failing ART.…”
Antiretroviral therapy (ART) has reduced morbidity and mortality related to human immunodeficiency virus (HIV) infection, but in spite of this advance, HIV mutations decrease antiretroviral susceptibility, thus contributing to treatment failure in patients. Genotyping HIV-1 allows the selection of new drugs after initial drug failure. This study evaluated the genotypic profi le of HIV-1 isolates from treated (drug-experienced) patients in Paraná, Brazil. The prevalence of mutations in reverse transcriptase (RT) and protease (PR) genes were assessed. We analyzed 467 genotypes of patients with HIV-1 viral loads above 1,000 copies/mL. Mutations at HIV-1 RT and PR genes and previously used ART regimens were recorded. The most prevalent RT mutations were: 184V (68.31%), 215YF (51.6%), 103NS (46%), 41L (39.4%), 67N (38.54%), 210W (23.5%), 190ASE (23.2%), and 181C (17.4%). PR mutations were 90M (33.33%), 82ATFS (29%), 46I (26.8%) and 54V (22.2%). The prevalence of mutations was in line with previous national and international reports, except to nonnucleoside analogue reverse transcriptase inhibitors related mutations, which were more prevalent in this study. Previous exposure to antiretroviral drugs was associated with genotypic resistance to specifi c drugs, leading to treatment failure in HIV patients.
In Italy, the prevalence of non-B HIV-1 subtypes ranges reportedly from 5.4% to 12.6%, yet there are no data on their circulation in prisons, where the prevalence of HIV infection is high. A retrospective study was conducted to evaluate the circulation of non-B subtypes and to characterize their determinants in five Italian prisons. To this end an aliquot of samples of blood was taken in the period 2001-2006 from all 262 HIV-positive inmates in whom antiretroviral treatment had failed. Complete HIV-1 PR and RT regions were sequenced for all samples and subjected to phylogenetic analysis; 250 (95.4%) sequences clustered with subtype B. The non-B subtype was found in 4% of Italian prison inmates and 16.7% of non-Italian prison inmates; the overall percentage increased from 1.8% for inmates infected in 1982-1990 to 4.4% in 1991-1999 and 21.9% in 2000-2006. Factors significantly associated with non-B subtypes were an exposure to other than injecting drug use and a first positive HIV test in 2000-2006. Non-B subtypes were distributed within five monophyletic clades. In all cases but one, it was possible to correlate the history of HIV-exposure to the origin of the clade, with high bootstrap values. In conclusion, although the sample may not be representative of the prison inmate population in Italy, the data suggest strongly that the circulation of non-B subtypes has apparently increased. Non-B subtypes were found to have been associated with heterosexual contact and time of the first HIV-positive test. Knowledge of the different subtypes circulating in prisons may be useful for tracking the epidemiology of HIV infection and for choosing antiretroviral therapy.
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