Abstract
In order to evaluate the genetic diversity of HIV-1 subtypes and transmitted drug resistance (TDR) mutations in northern Mozambique, we analyzed 120 plasma specimens obtained from drug naive blood donors candidates, who tested positive during routine HIV screening in three blood banks in that region. The genotyping for HIV-1 resistance was performed using Trugene Genotyping SystemTM. HIV-1 genetic subtypes were defined based on entire PR and partial RT gene regions, using REGA HIV-1 Subtyping Tool version 3.0 algorithm and confirmed by phylogenetic inference, using NJ algorithm. The majority of genotyped samples were classified as HIV-1 subtype C (80.0%), followed by subtype A1 (10.5%), subtype D (3.2%) and subtype G (2.1%). The inter-subtype recombinant forms (A1/C, A1/D and C/D) were identified in four participants (4.2%). TDR mutations associated with nucleoside and nonnucleoside reverse transcriptase inhibitors (K219E, G190A, K101E and K103N) were observed in five (5.3%) subjects. Although a large proportion of HIV-1 subtype C was observed, non-C and recombinant forms together correspond to 20% in this study, which is different from what was described in central and southern regions, where subtype C was almost 100%. However, the profile mutations from this study correlate with the ARVs used both for first line schemes and PMTCT in Mozambique. This data reinforces the necessity of continuous surveillance of HIV-1 diversity, TDR and routes of spread, through inner cities of Mozambique to understand better the dynamics of the HIV-1 epidemic and support national public health policies in the country.
Highlights
According to the estimate from the Joint United Nation Program on HIV/AIDS (UNAIDS), at the end of 2014; about 35.3 million people were living with HIV/AIDS
In this study we found that HIV subtype C is the most frequent in northern Mozambique
The finding of subtype C in three different cities from northern Mozambique reinforce the hypothesis that this subtype has been circulating as a major lineage, in the northern of Mozambique and in the south and center of the country [8,9]
Summary
According to the estimate from the Joint United Nation Program on HIV/AIDS (UNAIDS), at the end of 2014; about 35.3 million people were living with HIV/AIDS. Sub-Saharan African countries still remain the most affected with approximately 25 million people infected with HIV [1]. Phylogenetic analysis has revealed an extensive genetic diversity of HIV in Africa, composed of types 1 and 2, groups M, N, O and P, subtypes A-K, circulating recombinant forms (CRFs) and many unique recombinant forms (URFs) [2,3,4,5]. Mozambique, a sub-Saharan country faces serious HIV epidemics, with an overall prevalence of 11.5% (1.6 million people) [1] within the adult population, with around one to four new infections/100 persons occurring each year [6,7]. The HIV-1 epidemic in Mozambique is mainly driven by the subtype C infections [8,9,10,11,12]. Others non-C subtypes specially subtype A1 and D have been identified in limited number of cases mainly in the northern region [13]
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