Epidemiological, Clinical and Antiretroviral Susceptibility Characterization of Human Immunodeficiency Virus Subtypes B and Non-B in Pernambuco, Northeast Brazil

Abstract

BackgroundHIV-1 diversity causes important differences in the virus’ biological properties and their interactions with hosts, such as cell tropism, responses to antiretroviral therapy, drug-resistance, and disease progression.ObjectivesWe evaluated the interrelationship of phylogenetic inference with epidemiological and laboratory data for HIV-1 isolates circulating in Pernambuco, Northeast Region—Brazil.Study designA total of 168 HIV-1 pol sequences were analysed, 64 were obtained from 2002–2003, and 104, from 2007–2009. Socio-demographic, clinical, and behavioural data were obtained from medical records. Laboratory testing enabled the determination of recent HIV-1 infections and co-infections with HBV, HCV, HTLV, or syphilis. Surveillance drug-resistance mutation analysis and antiretroviral susceptibility profiling were performed using HIV Drug-Resistance Database.ResultsHIV-1 non-B was associated with female, lower education, lower viral loads, and higher T cell counts mean. Frequencies of co-infection HIV-HBV, HIV-HCV, and HIV-syphilis were 27.8% (95% CI: 19.8–37.7), 1.04% (95% CI: 0.05–5.00) and 14.7% (95% CI: 8.6–23.0), respectively. Drug-resistant mutations rate was 2.98% (95% CI: 1.10–6.47). HIV-HBV subtype B co-infection was associated with men who have sex with men (MSM), higher education, higher viral loads and males. HIV-syphilis subtype non-B co-infection was associated with MSM status, lower T cell counts and males.ConclusionsData showed the importance of molecular characterisations of the HIV-1 epidemic and its relation with epidemiological and clinical characteristics of the population, as well as its association with other infectious diseases, so they can effort to improve preventive measures for health services and more information about the progress and effects of the epidemic in Northeastern–Brazil.

Virologic suppression in response to antiretroviral therapy despite extensive resistance within HIV-1 reverse transcriptase after the first virologic failure

“…We observed that the salvage therapy regimen was predominantly composed of PI/r and NRTI(t)s, with virologic success in most cases. Subtype B remains the most common in Pernambuco [ 17 – 19 ] and in Brazil [ 11 ], except in the south, where subtype C [ 21 ] is predominant. There has been an increase in the proportion of recombinant forms in Rio de Janeiro [ 22 ] and subtype F in Minas Gerais [ 40 ].…”

Characterization of HIV-1 genetic diversity and antiretroviral resistance in the state of Maranhão, Northeast Brazil

“…In HIV-1 subtype B, two-thirds of the clusters networks were composed of male patients (6/9), with no information about of sexual exposure. Another study in Northeast Brazil [29] showed a higher number of men who have sex with men infected with HIV-1 subtype B when compared with non-B subtypes, nevertheless without statistical significance (p = 0.06).…”

Anais do I Congresso Online em Doenças Negligenciadas e Emergentes

“…Alguns estudos relacionam a presença do subtipo F com a transmissão heterossexual, na demonstração que o mesmo possuía mais mutações relacionadas à alguns antirretrovirais, como para Inibidores de Protease (IPs) do que o subtipo B, no qual é mais frequente nos países ocidentais. Além disso, outros trabalhos relacionam a presença deste subtipo a alguns grupos epidemiológicos e à menor carga viral e maior contagem de células T CD4+ (LIMA, et al 2016). Na epidemia brasileira do HIV-1, a distribuição do subtipo F é bastante heterogênea.…”

“…No País, a primeira identificação do subtipo F aconteceu em quatro amostras coletadas entre 1989-1990(LOUWAGIE, et al, 1994. A dispersão de subtipos não-B, incluindo o HIV-1 F, tem acometido várias regiões do País, além de, estarem associados a diferenças na patogênese ao serem comparados ao subtipo B (LIMA, et al, 2016). Entretanto, há poucos dados sobre a influência deste subtipo em diversas populações, seu papel na origem de recombinantes BF e na delimitação de características moleculares desta variante.…”