HIV‐1 primary and secondary antiretroviral drug resistance and genetic diversity among pregnant women from central Brazil

Abstract

Antiretroviral (ARV) resistance mutations in HIV-1 may reduce the efficacy of prophylactic therapy to mother-to-child transmission and impact future treatment options. ARV resistance mutations and HIV-1 phylogenetic diversity in protease (PR) and reverse transcriptase (RT) genes were assessed among 77 pregnant women (35 naïve, 42 treated with ARV) from Goiânia/Goiás, central west Brazil. ARV mutations in PR/RT genes were analyzed against the Stanford Database, PR/RT HIV-1 subtypes were assigned by phylogenetic analysis and env/gag subtypes were identified by heteroduplex mobility analysis (HMA). Naïve patients had accessory mutations in the PR gene [A71T (1/6), L10V (2/6), L10I (3/6)] and in the RT gene [V118I (2/6), V179D (1/6), V106I (1/6), K101Q (1/6), H221Y (1/6)]. Seven patients (16.7%) under ARV presented drug resistance mutations, one of them to three ARV classes. Most isolates (67.5%) were subtype B, 11.7% subtype F1 and 3.9% subtype C. Recombinant B(PR)/F1(RT) viruses represented 10.4% while F1(PR)/B(RT) viruses made up 6.5%. HIV-1 envgag/PRRT genes were identified as 66.2% subtype B, 3.9% subtype C, 6.5% subtype F1 and approximately 25% B and F1 viruses. HIV-1 genetic diversity in envgag/PRRT genes indicates the spread and dissemination of BF1 recombinant viruses among a significant proportion of patients from central west Brazil. Moreover, discovery of HIV-1 secondary resistance among a considerable number of pregnant women under ARV therapy indicates the importance of genotypic testing during pregnancy for optimal prophylactic intervention. J. Med. Virol. 82:351-357, 2010. (c) 2010 Wiley-Liss, Inc.

Southern Brazil HIV Type 1 C Expansion into the State of São Paulo, Brazil

“…This and other neighboring countries, such as Argentina, along with most Brazilian cities, had shown only sporadic identification of clade C. 2,7 In central Brazil, clade C has been reported in a few cases, below 4%. 3 In Rio de Janeiro a study at a local blood bank identified one sample (1.4%) of a BC mosaic. 12 In Sã o Paulo, a study from our group identified a low proportion (0.5%) in samples from 1998-2003, which represented 2.3% if only ARV-naive cases were considered.…”

“…Non-B non-F variants are occasionally observed. 3,6,7 In this study, we evaluated the presence and growth trends of HIV-1 C in Sã o Paulo and Campinas, the two largest metropolitan areas of Sã o Paulo state.…”

Heterosexual transmission of human immunodeficiency virus type 1 subtype C in southern Brazil

“…1). [2][3][4][5] However in the Southern region, a distinct profile is observed. Currently, depending on the state, 27-79% of HIV infections are caused by HIV-1C, 23-45% by HIV-1B, 3-29% by CRF31 BC and other BC recombinants, and HIV-1F and its recombinants account for up to 10% of infections.…”

Identification of Novel Resistance-Related Polymorphisms in HIV-1 Subtype C RT Connection and RNase H Domains from Patients Under Virological Failure in Brazil

“…2,3 In Brazil, the major circulating HIV-1 subtype is B (HIV-1B), yet other subtypes such as A1, C, D, F1, BF1, and BC recombinants have also been found. [4][5][6][7] The southern region of Brazil is unique, with an endemicity of HIV-1 subtype C (HIV-1C). Several studies have reported an increase in HIV-1C prevalence in that region.…”