Molecular Epidemiology of HIV-1 Virus in Puerto Rico: Novel Cases of HIV-1 Subtype C, D, and CRF-24BG

Abstract

HIV-1 subtype B virus is the most prevalent subtype in Puerto Rico (PR), accounting for about 90% of infection in the island. Recently, other subtypes and circulating recombinant forms (CRFs), including F(12_BF), A (01_BF), and CRF-39 BF-like, have been identified. The purpose of this study is to assess the distribution of drug resistance mutations and subtypes in PR. A total of 846 nucleotide sequences from the period comprising 2013 through 2017 were obtained from our "HIV Genotyping" test file. Phylogenetic and molecular epidemiology analyses were performed to evaluate the evolutionary dynamics and prevalence of drug resistance mutations. According to our results, we detected a decrease in the prevalence of protease inhibitor, nucleoside reverse transcriptase inhibitor (NRTI), and non-NRTI (NNRTI) resistance mutations over time. In addition, we also detected recombinant forms and, for the first time, identified subtypes C, D, and CRF-24BG in PR. Recent studies suggest that non-subtypes B are associated with a high risk of treatment failure and disease progression. The constant monitoring of viral evolution and drug resistance mutation dynamics is important to establish appropriate efforts for controlling viral expansion.

Short Communication: Integrase Strand Transfer Inhibitors Drug Resistance Mutations in Puerto Rico HIV-Positive Individuals

“…This sequence did not harbor any major or accessory drug resistance mutations to INSTIs; however, it presented a polymorphic accessory mutation (L74I) common among 20% of the studied patients but with no significant effect by itself. This finding correlates with previous studies that indicate that about 95–98.9% of the HIV-1 virus in PR is subtype B, with the remainder corresponding to subtypes A (A1, A/E), C, D, F, B/D, and CRF-24BG [ 25 , 26 ]. No transmitted drug resistance (TDR) to INSTIs was detected among the sequences from our ART-naïve patients.…”

“…The INSTI-resistance mutations percentage is relatively low when compared with mutations that can compromise nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) in Puerto Rican patients during a similar period [ 25 ]. This low frequency of drug resistance mutations could be related to the relatively new introduction of these drugs into the ART regimen in PR [ 40 , 41 ].…”