Epidemiological and Molecular Characteristics of HIV-1 Infection in a Sample of Men Who Have Sex With Men in Brazil: Phylogeography of Major Subtype B and F1 Transmission Clusters

Abstract

This study describes human immunodeficiency virus 1 (HIV-1) prevalence, associated factors, viral genetic diversity, transmitted drug resistance (TDR), and acquired drug resistance mutations (DRM) among a population of 522 men who have sex with men (MSM) recruited by the respondent-driven sampling (RDS) method, in Goiânia city, the capital of the State of Goiás, Central-Western Brazil. All serum samples were tested using a four-generation enzyme-linked immunosorbent assay (ELISA), and reactive samples were confirmed by immunoblotting. Plasma RNA or proviral DNA was extracted, and partial polymerase (pol) gene including the protease/reverse transcriptase (PR/RT) region was amplified and sequenced. HIV-1 subtypes were identified by phylogenetic inference and by bootscan analysis. The time and location of the ancestral strains that originated the transmission clusters were estimated by a Bayesian phylogeographic approach. TDR and DRM were identified using the Stanford databases. Overall, HIV-1 prevalence was 17.6% (95% CI: 12.6–23.5). Self-declared black skin color, receptive anal intercourse, sex with drug user partner, and history of sexually transmitted infections were factors associated with HIV-1 infection. Of 105 HIV-1-positive samples, 78 (74.3%) were sequenced and subtyped as B (65.4%), F1 (20.5%), C (3.8%), and BF1 (10.3%). Most HIV-1 subtype B sequences (67%; 34 out of 51) branched within 12 monophyletic clusters of variable sizes, which probably arose in the State of Goiás between the 1980s and 2010s. Most subtype F1 sequences (n = 14, 88%) branched in a single monophyletic cluster that probably arose in Goiás around the late 1990s. Among 78 samples sequenced, three were from patients under antiretroviral therapy (ART); two presented DRM. Among 75 ART-naïve patients, TDR was identified in 13 (17.3%; CI 95%: 9.6–27.8). Resistance mutations to non-nucleoside reverse transcriptase inhibitors (NNRTI) predominated (14.7%), followed by nucleoside reverse transcriptase inhibitor (NRTI) mutations (5.3%) and protease inhibitor (PI) mutations (1.3%). This study shows a high prevalence of HIV-1 associated with sexual risk behaviors, high rate of TDR, and high genetic diversity driven by the local expansion of different subtype B and F1 strains. These findings can contribute to the understanding about the dissemination and epidemiological and molecular characteristics of HIV-1 among the population of MSM living away from the epicenter of epidemics in Brazil.

Differences in risky sexual behaviors and HIV prevalence between men who have sex with men and transgender women in the Midwest Brazil

“…All subtype B sequences were classified as pandemic B. High frequency of recombinants have been described by other authors for different HIV-infected populations, including Brazilian MSM [ 12 , 41 – 44 ]. Here, all but one recombinant were detected in TW.…”

Herpes, Syphilis, and Human Immunodeficiency Virus Coinfection Among Transgender Women in Central Brazil

“…Several investigations have reported a higher risk of STIs among men who have sex with men 19 . Individuals who reported sex not only with men had a 2.42-fold increased risk of triple infection.…”

“…Several investigations have reported a higher risk of STIs among men who have sex with men. 19 Individuals who reported sex not only with men had a 2.42-fold increased risk of triple infection. We did not assess sexual risk behavior according to the sexual orientation of participants.…”

“…Transgender women were recruited using respondent-driven sampling, a peer-recruitment method which has been widely used for recruiting hard-to-reach populations. 19,20 For this purpose, 8 TGW were initially selected as "seeds" based on their popularity among their peers. Each seed recruited 3 new participants, and each of these 3 participants recruited a further 3 participants.…”

Transmission and Drug Resistance Characteristics of Human Immunodeficiency Virus-1 Strain Using Medical Information Data Retrieval System

“…The emergence of drug resistance strains causes the virus to be insensitive to or less sensitive to drugs, which is the main reason for the failure of antiviral treatment [ 26 ]. Silva et al [ 27 ] studied 75 patients who received antiretroviral therapy, of which 13 patients (17.3%) had a TDR (95% confidence interval: 9.6-27.8). Drug resistance mutations to NNRTI were dominant (14.7%), followed by NRTI (5.3%) and protease inhibitors (PI) (1.3%).…”