HIV-1 subtypes and profiles of resistance to protease inhibitors in the Marajo Archipelago (Brazilian Amazon region)

Samantha Assis Assis-Aguiar,Antonio C Rosario-Vallinoto ,Samara T Monteiro-Gomes,Marluísa O Guimarães-Ishak,Maria A Freitas-Queiroz,Ricardo Ishak,Izaura Maria Vieira Cayres-Vallinoto ,Felipe Bonfim-Freitas,Mike Batista Dos Santos

doi:10.54034/mic.e1173

Samantha Assis Assis-Aguiar, Antonio C Rosario-Vallinoto + Show 7 more

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https://doi.org/10.54034/mic.e1173

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Abstract

The Marajo Archipelago, located in the rural area of the state of Para (Amazon region of Brazil), is the region with the lowest index of human development in the country, presenting poor health services, which makes adequate epidemiological surveillance of HIV-1 infection difficult. After a serological screening enrolling 1,877 samples, three samples were diagnosed with HIV-1 and the pro gene was sequenced to evaluate the presence of resistance mutations to protease inhibitors. Molecular analyses revealed, for the first time in the region of Marajo Island, the occurrence of HIV-1 subtypes B and D, as well as the presence of transmitted high and intermediate protease inhibitors resistance mutations. The results emphasize the importance of ongoing molecular epidemiological surveillance studies in the Brazilian Amazon region because antiretroviral (ARV) resistance mutations may limit treatment options, and the presence of certain subtypes seems to influence the progression to AIDS, particularly in areas where the entry and spread of the virus can be facilitated by socio-demographic problems that expose the population to sexually transmitted infections.

Highlights

The genetic variability of human immunodeficiency virus 1 (HIV-1) leads to the classification into four groups (M, N, O, P); M includes the vast majority of infections and is divided into nine subtypes (A, B, C, D, F, G, H, J and K), circulating recombinant forms (CRF) and in unique recombinant forms (URF)
In the present study we report the first cases of HIV-1 subtypes B and D infections in the Marajo archipelago and the occurrence of mutations to protease inhibitors
Sequence alignment was performed in two steps: the first was to obtain the consensus sequence of the samples, and the second step was to evaluate the alignment of the consensus sequence with reference sequences of all HIV-1 M group subtypes obtained in the database of the Los Alamos National Laboratory (NIH, USA) using the ClustalW tool in BioEdit software version 7.1.9

Summary

Introduction

The genetic variability of human immunodeficiency virus 1 (HIV-1) leads to the classification into four groups (M, N, O, P); M includes the vast majority of infections and is divided into nine subtypes (A, B, C, D, F, G, H, J and K), circulating recombinant forms (CRF) and in unique recombinant forms (URF). Studies in the Amazon region of Brazil have revealed the predominance of subtypes B and F(4), and the presence of subtypes C and D and of the recombinant form CRF02-AG has been reported[5]. Another consequence of the high genetic variability of HIV-1 is the emergence of strains with antiretroviral (ARV) resistance mutations, which has been a major concern because the transmission of these variants to other individuals may alter the progression of the infection and limit treatment options over time[6,7]. To monitor the circulating subtypes in the Amazon region of Brazil, as well as strains with acquired resistance mutations, is of great relevance as they may contribute to the development of epidemiological surveillance actions against HIV-1

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