HIV-1 genetic diversity and antiretroviral drug resistance among individuals from Roraima state, northern Brazil

Abstract

The HIV-1 epidemic in Brazil has spread towards the Northern country region, but little is known about HIV-1 subtypes and prevalence of HIV strains with resistance mutations to antiretrovirals in some of the Northern states. HIV-1 protease (PR) and reverse transcriptase (RT) sequences were obtained from 73 treatment-naive and -experienced subjects followed between 2013 and 2014 at a public health reference unit from Roraima, the northernmost Brazilian state. The most prevalent HIV-1 clade observed in the study population was the subtype B (91%), followed by subtype C (9%). Among 12 HIV-1 strains from treatment-naïve patients, only one had a transmitted drug resistance mutation for NNRTI. Among 59 treatment-experienced patients, 12 (20%) harbored HIV-1 strains with acquired drug resistance mutations (ADRM) that reduce the susceptibility to two classes of antiretroviral drugs (NRTI and NNRTI or NRTI and PI), and five (8%) harbored HIV-1 strains with ADRM that reduced susceptibility to only one class of antiretroviral drugs (NNRTI or PI). No patients harboring HIV strains with reduced susceptibility to all three classes of antiretroviral drugs were detected. A substantial fraction of treatment-experienced patients with (63%) and without (70%) ADRM had undetectable plasma viral loads (<40 copies/ml) at the time of sampling. Among treatment-experienced with plasma viral loads above 2,000 copies/ml, 44% displayed no ADRM. This data showed that the HIV-1 epidemic in Roraima displayed a much lower level of genetic diversity and a lower prevalence of ADRM than that described in other Brazilian states.

HIV-1 genetic diversity and resistance to antiretroviral drugs among pregnant women in Ribeirão Preto (SP), Brazil. Cross-sectional study

“…This was consistent with other data from Brazil [12][13][14][15][16][17][18][19][20] with the exception of the southern states, where subtype C has been found to prevail. 21 To a lesser extent, presence of recombinant forms between subtypes B and F, K and between F and subtype F1 was also found.…”

“…Subtype C was not observed in the samples, but the prevalence of this subtype is increasing in Brazil, 22 apparently with disease progression characteristics differing from those of subtype B. 23 Subtype F is the second most common form in the cities of Santos 24,25 and Rio de Janeiro 18 and in the states of Minas 12,13,16,17,25,27 Ferreira et al 22 found that the prevalence of transmitted drug resistance in São Paulo and Campinas was 7.6% and that 76.0% of these cases carried mutations for resistance to NNRTIs.…”

“…Among the cARVT- Other studies on patients who had already been treated with several antiretroviral regimens also observed higher frequency of the M184V mutation, in up to 88.0% of the individuals evaluated. 14,17,24 It was expected to find drug-resistant mutations among women who had had a diagnosis of HIV infection for a longer time, had had a previous event of opportunistic infection and presented a worse clinical and immunological stage of the disease. However, cARVT-exposed pregnant women who had had a diagnosis of HIV infection for up to five years did not have any mutations in the reverse transcriptase segment and only had accessory mutations present in protease segment.…”

Detection of human immunodeficiency virus Type 1 phylogenetic clusters with multidrug resistance mutations among 2011 to 2017 blood donors from the highly endemic Northern Brazilian Amazon

“…Different rates of TDR to the main ARV drug classes nucleoside and nonnucleoside reverse transcriptase inhibitors (NRTI and NNRTI, respectively) and protease inhibitors (PI) have been reported in Brazil, mostly ranging from 5% to 15% . In Northern Brazil, TDR rates ranging from 0% to 21% have been reported; however, studies from this region are still scarce …”

Estimating HIV-1 Genetic Diversity in Brazil Through Next-Generation Sequencing

“…The higher prevalence of recombinant forms when compared to recent Brazilian Sanger sequencing-based studies (ranging from 5 to 16%) can be attributed to the smaller genomic region analyzed in the latter, mostly based only on pol gene, which impairs the accurate classification of recombinants (Librelotto et al, 2015; Moura et al, 2015; da Costa et al, 2016; Dos Anjos Silva et al, 2016; Delatorre et al, 2017; Filho and Brites, 2017; Lima et al, 2017). Some of these studies covering small genomic regions could not find recombinant strains, like the study conducted by Corado et al (2017) among 73 individuals from Roraima state, northern Brazil. A study conducted by Graf et al (2016) found a higher proportion of recombinant strains than others Sanger-based studies (21%, 66/317).…”