HIV-1 Molecular Epidemiology, Transmission Clusters and Transmitted Drug Resistance Mutations in Central Brazil

Abstract

We aimed to characterize HIV-1 molecular epidemiology and transmission clusters among heterosexual (HET) and men who have sex with men (MSM) individuals, as well as transmitted drug resistance mutations (TDRM) in Central-Western Brazil. This cross-sectional survey was conducted among 190 antiretroviral naïve HIV-1 infected individuals. Proviral DNA was extracted, and nested PCR amplified partial polymerase gene (PR/RT). After sequencing, subtypes were assigned, and the sequences were analyzed for the occurrence of possible transmission networks. Calibrated Population Resistance (CPR) tool from Stanford HIV Database was used to investigate the presence of TDRM. Among 150 individuals whose samples were successfully sequenced, the most prevalent HIV-1 subtype was B, followed by recombinant forms. The occurrence of twenty transmission clusters composed by at least two sequences was verified, suggesting the existence of transmission clusters among individuals from the same or distinct sexual orientations. Intermediate level of TDRM (12%) was found in the study population, and almost half of the subjects with TDRM had more than one resistance mutation. No correlations between sexual orientation and the presence of TDRM, HIV-1 subtypes/recombinants forms were verified. Taken together, the necessity of the continuous monitoring of the TDRM to verify the importance of pre-genotyping and to delineate future strategies in primary antiretroviral therapy. Likewise, the knowledge of the HIV-1 transmission networks in Brazil would allow the implementation of effective HIV-1 prevention strategies in local settings.

Increased HIV-1 pretreatment drug resistance with consistent clade homogeneity among ART-naive HIV-1 infected individuals in Ethiopia

“…The lower frequency of NRTI and PI associated mutations observed in this study are in agreement with previously conducted studies among ART-naive individuals in Ethiopia [16,17,23,31,32]. Likewise, similar NRTI and PI associated PDRMs were reported in other countries like Brazil [26] and India [25].…”

“…Similarly, a study done in Brazil among ART-naive pregnant women indicated a lower PDR detection rate [ 24 ]. In addition to the above previously published data from Ethiopia, this finding is in agreement with studies done in India [ 25 ], Brazil [ 26 – 28 ], China [ 29 ], and Iran [ 30 ], which reported a moderate magnitude of PDR among HIV-1 antiretroviral adults. The absence of PDRM screening before starting ART and poor level of adherence might have contributed to this increment of PDR in the current study.…”

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

“…On the other hand, only the M46L PI resistance mutation was detected, which is associated with reduced susceptibility to atazanavir (ATV) and lopinavir (LPV). The low prevalence of PI mutations found (1.3%) is in accordance with other national studies (Arruda et al, 2018;Crispim et al, 2019;Tanaka et al, 2019).…”

“…As reported elsewhere (Arruda et al, 2018), NNRTI mutations predominated in our study and the 14.7% prevalence rate here found was higher than those reported in a Brazilian nationwide study (5.8%; ranging from 4.5% in Central-West and Northeast to 7.0% in South) (Arruda et al, 2018). The most frequent NNRTI mutation detected, K103N (6.7%) was also observed in high rates in other studies conducted in Brazil (Bermúdez-Aza et al, 2011;Arruda et al, 2018;Crispim et al, 2019;Tanaka et al, 2019). It is a non-polymorphic mutation that causes high-level resistance to nevirapine (NVP) and efavirenz (EFV).…”

Contribution of transgender sex workers to the complexity of the HIV-1 epidemic in the metropolitan area of Milan

“…Although the B subtype is dominant in South America, F1 and C clades cocirculates at high levels, generating a growing number of circulating recombinant forms (CRFs) and unique recombinant forms (URFs), making the epidemic of this continent highly complex 9 10. In Italy, among non-B subtypes, F1, A1 and C clades are prevalent, affecting 77.2% of HEs 11.…”