We evaluate the genetic characterization of 132 HIV‐1 pol sequences from children and adolescents undergoing antiretroviral therapy in Northeast Brazil. Phylogenetic and recombination analyses were performed using the maximum likelihood method using SeaView version 4 and SIMPLOT software. Most individuals harbored HIV‐1 B (84.8%) and BF recombinants (9.8%), although other non‐B subtypes were detected: HIV‐1 C (1.5%), HIV‐1 F (2.4%), and BC recombinants (1.5%). Antiretroviral resistance was 47% (95% confidence interval [CI]: 38.7%–55.4%). Non‐nucleoside reverse transcriptase inhibitors (NNRTIs) showed higher frequencies of primary mutations, with 40.9% (95% CI: 32.9%–49.4%), followed by nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitors (PIs) with 34.8% (95% CI: 27.3–43.3) and 6.1% (95% CI: 3.1%–11.5%), respectively. Among NRTIs, higher resistance levels were observed for abacavir, emtricitabine, and lamivudine; for NNRTI, nevirapine and efavirenz. The most common primary mutations found were M184V (29.5%), K103N (25%), M41L (9.8%), T215Y (8.3%), and G190A (8.3%). Our findings highlight the importance of surveillance of resistance mutations, which contributes to the continuous updating and implementation of preventive measures to decrease mother‐to‐child‐transmission and transmitted drug resistance.

The HIV-1 epidemic in Brazil has been growing in northeast and north regions, particularly an increase in AIDS cases among the younger male population has been observed. This study aims to characterize the HIV-1 genetic diversity and to evaluate its antiretroviral resistance profile among individuals presenting virological failure in the state of Maranhão-Brazil. HIV-1 pol gene sequences from 633 patients on antiretroviral therapy were obtained from the Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis of the Brazilian Ministry of Health. Phylogenetic and recombination analyses were performed to characterize viral genetic diversity. The presence of antiretroviral resistance mutations was assessed using the HIV Drug Resistance Database online platform of Stanford University. A predominance of subtype B (84.5%) was observed, followed by recombinant BF (9.5%), where more than half of the sequences were dispersed in 3 clusters. Antiretroviral resistance was detected in 74.1% of the sequences, and it was significantly higher for nucleoside analogue reverse-transcriptase inhibitors (NRTIs) than for non-nucleoside analogue reverse-transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs). Inference of putative transmissions clusters identified 11 clusters with 22 query sequences (22/633, 3.5%). Thus, we conclude that continuous monitoring of the molecular epidemiology of HIV-1 is essential for prevention strategies, epidemic control, and treatment adequacy.

Introdução: A prática de atividades físicas por pessoas vivendo com vírus da imunodeficiência humana tem sido recomendada reiteradamente na literatura médica. Tal medida não farmacológica mostra-se eficaz na prevenção e no tratamento de quadros clínicos de dislipidemia, lipodistrofia e resistência à insulina associados tanto à ação do vírus quanto aos efeitos adversos da terapia antirretroviral. No entanto, estima-se que apenas 50,7% das pessoas vivendo com vírus da imunodeficiência humana estejam em conformidade com as diretrizes de exercícios físicos recomendadas. Objetivo: Analisar a prevalência e os fatores associados à prática de atividades físicas em pessoas vivendo com vírus da imunodeficiência humana. Métodos: Trata-se de um estudo observacional retrospectivo formado por 276 pessoas vivendo com vírus da imunodeficiência humana em terapia antirretroviral, atendidos no Serviço Ambulatorial Especializado de um município do interior do Maranhão durante o ano de 2018. As variáveis analisadas foram prática de atividades físicas, sexo, idade, peso e escore de risco de Framingham. Classificou-se a amostra em dois grupos: praticantes e não praticantes de atividade física. Para a análise estatística utilizou-se o software SPSS® versão 19.0. Os resultados foram considerados significativos se p <0,05. Resultados: Entre os participantes do estudo, 44,6% (n=123) eram mulheres e 55,4% (n=153) eram homens. Ademais, desse contingente total de pacientes, 67% (n=185) eram não praticantes de atividades físicas e, desses, 91,4% (n=169) possuíam baixo risco de eventos cardiovasculares, segundo escore de risco de Framingham, e 8,6% possuíam risco moderado e alto. O grupo praticante de atividades físicas apresentou menor mediana na variável idade [37 (31–45) anos, p=0,004] e maior mediana na variável peso [68 (60–77,5) kg, p=0,015]. Entre os praticantes de atividades físicas, houve uma alta prevalência de risco baixo, onde 98,9% (n=90) apresentaram risco baixo e apenas 1,1% (1) de risco moderado e alto. Conclusão: A ausência da prática de atividades físicas é prevalente entre pessoas vivendo com vírus da imunodeficiência humana e estes estão mais associados ao moderado e alto risco de eventos cardiovasculares. Nesse sentido, é essencial que a equipe do Serviço Ambulatorial Especializado priorize ações que influenciem a prática de atividades físicas a fim de evitar morte precoce por doença cardiovascular.

Background: Acquired Immunodeficiency Syndrome (Aids) comes along the years promoting inversion of the relation men/women, committing mainly the productive and reproductive life phase women. The sexuality, inherent upon human being, has in the expression of satisfaction of the sexual performance the possibility of providing several benefits in the quality of life of people, and CD4 + T-lymphocytes are the main marker of immunity of the women living with Aids. This study aims to show up the association between the CD4 + count and the sexual performance of women living with Aids in Imperatriz city.Methods and Findings: cross-sectional analytical study, carried out in 10 months, selecting women using antiretroviral therapy at least six months, including those older than 18, having sexual practice before having Aids , able to answer two questionnaires. Socio-demographic facts were recorded in own form, and sexual performance in the FSFI questionnaire. The sample based in 479 women, sampling error 5%, confidence interval 95%, alpha value ≤ 5%, included 149 women. Chi-square test was used to evaluate the association between the variables. The larger FSFI score means and medians coincided with the highest means of CD4 + T-lymphocyte count (Kruskal Wallis test, p = 0.0347), and a positive association between FSFI and the CD4+/CD8 ratio (Spearman test, p = 0.0264), confirming the alternative hypothesis. Conclusion:In this sample there was a positive association between sexual performance /sexual activity, with or without a condom, with CD4 + T-lymphocyte count and CD4+/CD8 ratio.