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

Lima, Kledoaldo; Leal, Élcio; Cavalcanti, Ana Maria Salustiano; Salustiano, Daniela Medeiros; Medeiros, Luzidalva Barbosa de; Silva, Sirleide Pereira da; Lacerda, Heloísa Ramos

doi:10.1371/journal.pone.0155854

Cited by 7 publications

(5 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings showed that subtype B had a lower median CD4 T-cell count compared to subtypes F1 and C, as also recorded in previous studies ( 24 ), however, that comparison revealed no differences in viral load levels between the HIV-1 subtypes. This study has not performed any survival analyses on the three subtypes, though other authors have suggested an association between the viral subtype and progression to AIDS ( 25–28 ).…”

Section: Discussionsupporting

confidence: 90%

Dynamics and features of transmission clusters of HIV-1 subtypes in the state of São Paulo, Brazil

Pimentel,

Pineda-Peña,

Sebastião

et al. 2024

Front. Public Health

View full text Add to dashboard Cite

BackgroundMolecular epidemiology techniques allow us to track the HIV-1 transmission dynamics. Herein, we combined genetic, clinical and epidemiological data collected during routine clinical treatment to evaluate the dynamics and characteristics of transmission clusters of the most prevalent HIV-1 subtypes in the state of São Paulo, Brazil.MethodsThis was a cross-sectional study conducted with 2,518 persons living with HIV (PLWH) from 53 cities in São Paulo state between Jan 2004 to Feb 2015. The phylogenetic tree of protease/reverse transcriptase (PR/RT) regions was reconstructed by PhyML and ClusterPicker used to infer the transmission clusters based on Shimodaira–Hasegawa (SH) greater than 90% (phylogenetic support) and genetic distance less than 6%.ResultsOf a total of 2,518 sequences, 2,260 were pure subtypes at the PR/RT region, being B (88%), F1 (8.1%), and C (4%). About 21.2% were naïve with a transmitted drug resistance (TDR) rate of 11.8%. A total of 414 (18.3%) of the sequences clustered. These clusters were less evident in subtype B (17.7%) and F1 (15.1%) than in subtype C (40.2%). Clustered sequences were from PLWH at least 5 years younger than non-clustered among subtypes B (p < 0.001) and C (p = 0.037). Men who have sex with men (MSM) predominated the cluster in subtype B (51%), C (85.7%), and F1 (63.6%; p < 0.05). The TDR rate in clustered patients was 15.4, 13.6, and 3.1% for subtypes B, F1, and C, respectively. Most of the infections in subtypes B (80%), C (64%), and F1 (59%) occurred within the state of São Paulo. The metropolitan area of São Paulo presented a high level of endogenous clustering for subtypes B and C. The São Paulo city had 46% endogenous clusters of subtype C.ConclusionOur findings showed that MSM, antiretroviral therapy in Treatment-Naive (ART-naïve) patients, and HIV1-C, played an important role in the HIV epidemic in the São Paulo state. Further studies in transmission clusters are needed to guide the prevention intervention.

show abstract

Section: Discussionsupporting

confidence: 90%

Dynamics and features of transmission clusters of HIV-1 subtypes in the state of São Paulo, Brazil

Pimentel,

Pineda-Peña,

Sebastião

et al. 2024

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…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 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

View full text Add to dashboard Cite

BackgroundIncomplete virologic suppression results in mutations associated with resistance and is a major obstacle to disease control. We analyzed the genotypic profiles of HIV-1 patients at the time of the first virologic failure and the response to a salvage regimen after 48 weeks.MethodsThis work was a cross-sectional, retrospective, analytical study based on data collected from medical records and genotyping tests between 2006 and 2016. The sample consisted of data on individuals living with HIV (PLWH) from three major reference centers.ResultsA total of 184 patients were included in the data analysis. Viral subtype B was the most common (81.3%) as well as M184 V/I (85.3%) and K103 codon mutations (65.8%). Forty-eight weeks after switching to a salvage regimen, 67.3% of patients achieved an undetectable viral load.DiscussionThe number of mutations associated with nucleos(t)ide reverse transcriptase inhibitors (NRTI(t)s) did not affect virologic suppression (9.3% for zero NRTI(t)-associated mutations vs 48.6% for 1–2 NRTI(t)-associated mutations vs 42.1% for ≥3 NRTI(t)-associated mutations, p = 0.179). An ARV time (the beginning of the first ARV regimen up to genotyping) of > 36 months was a protective factor for detectable viral load (PR = 0.60, 95% CI = 0.39–0.92, p = 0.020) and a risk factor for developing ≥3 NRTI(t)-associated mutations (PR = 2.43, 95% CI 1.38–4.28, p = 0.002).ConclusionsWe found that extensive resistance to NRTI(t)s at the time of the first virologic failure did not impact virologic suppression at 48 weeks after switching to a second-line therapy based on NRTI(t)s plus protease inhibitors.

show abstract

“…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).…”

Section: Discussionmentioning

confidence: 95%

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

et al. 2020

Self Cite

View full text Add to dashboard Cite

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.

show abstract

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

Cited by 7 publications

References 43 publications

Dynamics and features of transmission clusters of HIV-1 subtypes in the state of São Paulo, Brazil

Dynamics and features of transmission clusters of HIV-1 subtypes in the state of São Paulo, Brazil

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

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

Contact Info

Product

Resources

About