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

Kledoaldo Lima,Heloísa Ramos Lacerda,Ana Maria Salustiano Cavalcanti,Sirleide Pereira Da Silva,Élcio De Souza Leal,Daniela Medeiros Salustiano,Luzidalva Barbosa De Medeiros,Zhefeng Meng

doi:10.1371/journal.pone.0155854

Kledoaldo Lima, Heloísa Ramos Lacerda + Show 6 more

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https://doi.org/10.1371/journal.pone.0155854

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Abstract

BackgroundHIV-1 diversity causes important differences in the virus’ biological properties and their interactions with hosts, such as cell tropism, responses to antiretroviral therapy, drug-resistance, and disease progression.ObjectivesWe evaluated the interrelationship of phylogenetic inference with epidemiological and laboratory data for HIV-1 isolates circulating in Pernambuco, Northeast Region—Brazil.Study designA total of 168 HIV-1 pol sequences were analysed, 64 were obtained from 2002–2003, and 104, from 2007–2009. Socio-demographic, clinical, and behavioural data were obtained from medical records. Laboratory testing enabled the determination of recent HIV-1 infections and co-infections with HBV, HCV, HTLV, or syphilis. Surveillance drug-resistance mutation analysis and antiretroviral susceptibility profiling were performed using HIV Drug-Resistance Database.ResultsHIV-1 non-B was associated with female, lower education, lower viral loads, and higher T cell counts mean. Frequencies of co-infection HIV-HBV, HIV-HCV, and HIV-syphilis were 27.8% (95% CI: 19.8–37.7), 1.04% (95% CI: 0.05–5.00) and 14.7% (95% CI: 8.6–23.0), respectively. Drug-resistant mutations rate was 2.98% (95% CI: 1.10–6.47). HIV-HBV subtype B co-infection was associated with men who have sex with men (MSM), higher education, higher viral loads and males. HIV-syphilis subtype non-B co-infection was associated with MSM status, lower T cell counts and males.ConclusionsData showed the importance of molecular characterisations of the HIV-1 epidemic and its relation with epidemiological and clinical characteristics of the population, as well as its association with other infectious diseases, so they can effort to improve preventive measures for health services and more information about the progress and effects of the epidemic in Northeastern–Brazil.

Highlights

HIV-1 is classified into 4 major groups: the major group (M), the non-major or non-outlier groups (N), the outlier group (O), and group P [1], which shows high genetic variability [2]
Frequencies of co-infection HIV-hepatitis B virus (HBV), HIV-hepatitis C virus (HCV), and HIV-syphilis were 27.8%, 1.04% and 14.7%, respectively
HIV-HBV subtype B co-infection was associated with men who have sex with men (MSM), higher

Summary

Introduction

HIV-1 is classified into 4 major groups: the major group (M), the non-major or non-outlier groups (N), the outlier group (O), and group P [1], which shows high genetic variability [2]. The HIV-1 genetic variability is related to several factors: the lack of fidelity of the reverse transcriptase (RT) that causes a high mutation rate, a high replication rate in vivo, and the potential for genetic recombination in cells co-infected with different viral strains [4,5,6]. Another factor that influences genome variability is the process of diversity bottlenecking that occurs during transmission to a new host, in which the virus progeny produced early in infection are derived from the expansion of only a few viral particles that are successfully transmitted. HIV-1 diversity causes important differences in the virus’ biological properties and their interactions with hosts, such as cell tropism, responses to antiretroviral therapy, drug-resistance, and disease progression

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