Drug resistance in antiretroviral-naive children newly diagnosed with HIV-1 in Manaus, Amazonas

Andrade, Solange Dourado de; Sabidó, Meritxell; Monteiro, Wuelton Marcelo; Benzaken, Adèle Schwartz; Tanuri, Amílcar

doi:10.1093/jac/dkx025

Cited by 14 publications

(19 citation statements)

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“…Subtype B was also highly prevalent in Pará state representing 97% of 34 protease sequences of pregnant women [25] and 85% in patients failing HAART [22]. A previous study in 31 HIV-1 sequences of blood donors from Amazonas also showed the predominance of subtype B [21] and a recent study in 129 antiretroviral naïve children from Manaus showed 80.2% subtype B infections [27]. Only subtype B was identified in Boa Vista, the capital of Roraima, the northern most Brazilian state, which is only connected by road to Amazonas state, Venezuela and Guyana.…”

Section: Discussionmentioning

confidence: 99%

“…Also, an escalating contribution of BF1 and BC hybrids classified as circulating recombinant forms (CRFs) or unique recombinant forms (URFs) have been described [14,16,17,18]. Data on the epidemiological and molecular features of this expanding AIDS epidemic in Northern Brazil are still scarce [17,19–27]. Mapping of HIV-1 genetic diversity can reveal the patterns of viral dissemination especially in a highly endemic, remote and geographically isolated region as Northern Brazil.…”

Section: Introductionmentioning

confidence: 99%

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Homogenous HIV-1 subtype B from the Brazilian Amazon with infrequent diverse BF1 recombinants, subtypes F1 and C among blood donors

et al. 2019

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In the last decade a growing HIV/AIDS epidemic with increased incidence and AIDS-related mortality has been reported in Northern Brazil from which molecular data are scarce. Also, apparently healthy, adult blood donors, recently diagnosed with HIV-1 represent important sentinel populations for molecular studies. This cross-sectional study describes HIV-1 subtypes in blood donors from three reference public blood centers located in three States in Northern Brazil. HIV-1 pol sequencing (protease/PR, reverse transcriptase/RT) was performed on plasma samples of HIV-1 positive donors from HEMOAM, Manaus, Amazonas (n = 198), HEMERON, Porto Velho, Rondônia (n = 20) and HEMORAIMA, Boa Vista, Roraima (n = 9) collected from 2011–2017. HIV-1 subtypes were identified by REGA, phylogenetic inference; recombinant viruses were characterized by SIMPLOT. Young, single, males predominated, around half was first-time donors. Syphilis co-infection was detected in 17% (39 out of 227), 8% (18 out of 227) was anti-HBc positive. Subtype B represented ≥ 90% in Amazonas, Rondônia and Roraima, subtype C (3.1%) was found in Amazonas and Rondônia; subtype F1 (0.9%) and BF1 recombinants (5.3%) were only detected in Amazonas. Subtype B sequences from Amazonas (n = 179), Rondônia (n = 18) and Roraima (n = 9) were combined with viral strains representative of the BPANDEMIC (n = 300) and BCARIBBEAN/BCAR (n = 200) lineages. The BPANDEMIC lineage predominated (78%) although BCAR lineages were frequent in Roraima (56%) and Amazonas (22%). Subtype C and subtype F1 sequences identified here clustered within Brazilian CBR and F1BR lineages, respectively. Twelve BF1 mosaics showed 11 different recombination profiles: six were singleton unique-recombinant-forms/URFs, one displays a CRF28/29_BF-like recombinant pattern and the remaining four BF1 isolates branched with other Brazilian BF1 viruses previously described and may represent putative new CRF_BF1 from Northern Brazil. Our study shows a highly homogeneous molecular pattern with prevalent subtype B, followed by BF1, and sporadic subtype C and F1 in blood donors from the Northern region. Surveillance studies are important to monitor HIV-1 diversity which can reveal patterns of viral dissemination, especially in a highly endemic, remote and geographically isolated region as Northern Brazil.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Homogenous HIV-1 subtype B from the Brazilian Amazon with infrequent diverse BF1 recombinants, subtypes F1 and C among blood donors

et al. 2019

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“…[3][4][5][6][7][8][9][10][11][12] In Northern Brazil, TDR rates ranging from 0% to 21% have been reported; however, studies from this region are still scarce. 8,[13][14][15][16][17] In the context of a highly endemic region for HIV/AIDS, apparently healthy blood donors recently diagnosed with HIV-1 infection represent important sentinel populations for the assessment of TDR/DRM. As part of the routine screening process of blood donors, it has been assumed that all HIV-1-positive blood donors were honest about not knowing their HIV-positive status and not taking any ARV that could otherwise readily select for DRM.…”

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confidence: 99%

Detection of human immunodeficiency virus Type 1 phylogenetic clusters with multidrug resistance mutations among 2011 to 2017 blood donors from the highly endemic Northern Brazilian Amazon

et al. 2019

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BACKGROUND This study describes transmitted drug resistance (TDR) in blood donors diagnosed with human immunodeficiency virus Type 1 (HIV‐1) infection from 2011 to 2017 in three reference public blood centers from the Northern Brazilian Amazon. STUDY DESIGN AND METHODS This was a cross‐sectional study on HIV‐positive blood donors from HEMOAM, Manaus, Amazonas, AM (n = 198); HEMERON, Porto Velho, Rondônia, RO (n = 20); and HEMORAIMA, Boa Vista, Roraima, RR (n = 9). HIV‐1 pol sequences (protease, reverse transcriptase) were analyzed for drug resistance mutations (DRMs) using the Calibrated Population Resistance tool (Stanford). TDR/DRM clusters were investigated by phylogenetic analysis after removing positions associated with drug resistance of Subtype B sequences from untreated and treated subjects from Northern Brazil. RESULTS Transmitted drug resistance/DRM in blood donors was 11% (25 of 227), all of them from HEMOAM. Most blood donors with TDR/DRM had multiple and similar DRMs. Nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations predominated (10.1%), followed by nucleoside reverse transcriptase inhibitor (NRTI) mutations (5.3%) and protease inhibitor mutations (0.4%). Dual‐class NNRTI/NRTI mutations represented 4.8%. Three highly supported Subtype B monophyletic clades mostly composed by individuals from Amazonas with TDR/DRM mutations were identified. The largest transmission cluster contained 10 sequences, eight from HEMOAM and two sequences described previously (one from a treated subject from Amazonas and the other one from Roraima). This cluster was characterized by NRTI (D67N, T69D, T215S/F/L, K219Q) and NNRTI (K101H, K103 N, G190A) mutations. The other two transmission clades comprised only three and two sequences from HEMOAM sharing the E138A NNRTI mutation. CONCLUSIONS The identification of transmission clusters of multidrug‐resistant viruses in blood donors from Amazonas highlight the need of continued monitoring of TDR/DRM and the importance of pretreatment genotyping in the highly endemic Amazonas state.

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“…La prevalencia total de mutaciones de resistencia (28,6%) y la de resistencias primarias (11,1%) en la población analizada es similar a la descrita en la región y en el mundo, pero fue más elevada en los casos de resistencia secundaria (60%) 23,[31][32][33][34][35][36][37] .…”

Section: Discussionunclassified

“…En Brasil, Andrade y cols., encontraron una prevalencia de resistencia primaria de 16,2%: 21,1% en niños expuestos a profilaxis para la TMI y 14,3% entre los niños no expuestos 36 .…”

Section: Discussionunclassified

Prevalencia de resistencia a los anti-retrovirales en niños y adolescentes uruguayos infectados con el virus de la inmunodeficiencia humana en el Centro de Referencia VIH-SIDA. Centro Hospitalario Pereira Rossell. Montevideo-Uruguay

González

Gutiérrez

2018

Rev. chil. infectol.

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Drug resistance in antiretroviral-naive children newly diagnosed with HIV-1 in Manaus, Amazonas

Cited by 14 publications

References 42 publications

Homogenous HIV-1 subtype B from the Brazilian Amazon with infrequent diverse BF1 recombinants, subtypes F1 and C among blood donors

Homogenous HIV-1 subtype B from the Brazilian Amazon with infrequent diverse BF1 recombinants, subtypes F1 and C among blood donors

Detection of human immunodeficiency virus Type 1 phylogenetic clusters with multidrug resistance mutations among 2011 to 2017 blood donors from the highly endemic Northern Brazilian Amazon

Prevalencia de resistencia a los anti-retrovirales en niños y adolescentes uruguayos infectados con el virus de la inmunodeficiencia humana en el Centro de Referencia VIH-SIDA. Centro Hospitalario Pereira Rossell. Montevideo-Uruguay

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