HIV-1 Molecular Epidemiology, Transmission Clusters and Transmitted Drug Resistance Mutations in Central Brazil

Grazielli Rocha De Rezende,Tayana Serpa Ortiz Tanaka,Thaysse Ferreira Leite,Ana Rita Coimbra Motta-Castro,Gabriela Alves Cesar,Monick Lindenmeyer Guimarães,Solange Zacalusni Freitas,Andrea De Siqueira Campos Lindenberg

doi:10.3389/fmicb.2019.00020

Abstract

We aimed to characterize HIV-1 molecular epidemiology and transmission clusters among heterosexual (HET) and men who have sex with men (MSM) individuals, as well as transmitted drug resistance mutations (TDRM) in Central-Western Brazil. This cross-sectional survey was conducted among 190 antiretroviral naïve HIV-1 infected individuals. Proviral DNA was extracted, and nested PCR amplified partial polymerase gene (PR/RT). After sequencing, subtypes were assigned, and the sequences were analyzed for the occurrence of possible transmission networks. Calibrated Population Resistance (CPR) tool from Stanford HIV Database was used to investigate the presence of TDRM. Among 150 individuals whose samples were successfully sequenced, the most prevalent HIV-1 subtype was B, followed by recombinant forms. The occurrence of twenty transmission clusters composed by at least two sequences was verified, suggesting the existence of transmission clusters among individuals from the same or distinct sexual orientations. Intermediate level of TDRM (12%) was found in the study population, and almost half of the subjects with TDRM had more than one resistance mutation. No correlations between sexual orientation and the presence of TDRM, HIV-1 subtypes/recombinants forms were verified. Taken together, the necessity of the continuous monitoring of the TDRM to verify the importance of pre-genotyping and to delineate future strategies in primary antiretroviral therapy. Likewise, the knowledge of the HIV-1 transmission networks in Brazil would allow the implementation of effective HIV-1 prevention strategies in local settings.

Highlights

In Latin America, it is estimated that 1.8 million people are living with human immunodeficiency virus (HIV) and/or acquired immunodeficiency syndrome (AIDS)
One hundred and seventy-two individuals were enrolled at Reference Centers for Parasitic and Infectious Diseases (Freitas et al, 2014), and thirty-two were men who have sex with men (MSM) recruited in a cross-sectional study (Fernandes et al, 2015)
No statistically significant correlation was detected between the variables presented in Table 1 and HIV-1 subtypes

Summary

Introduction

In Latin America, it is estimated that 1.8 million people are living with human immunodeficiency virus (HIV) and/or acquired immunodeficiency syndrome (AIDS). Despite 100,000 new HIV infections having been diagnosed in 2017, the HIV incidence decreased 13.7% between 2000 and 2017 (UNAIDS, 2018). In Brazil, HIV prevalence among the general population is below 0.6% and it is estimated that AIDS cases among Brazilians reached 882,810 by June 2017 (Brasil, 2017). HIV prevalence is higher in key populations at risk, for example 17.5% in men who have sex with men (MSM) (Kerr et al, 2018). The detection rate of AIDS has been falling steadily in Brazil in recent years. The Central Western region showed little change in its detection rate in the last 10 years, reaching 16.7 cases per 100 thousand inhabitants in 2016 (Brasil, 2017)

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