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ASSESSING THE HIV-1 EPIDEMIC IN BRAZILIAN DRUG USERS: A MOLECULAR EPIDEMIOLOGY APPROACH
Autor
Afiliación
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz.Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz.Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Brazilian Multicity Study Group on Drug Misuse.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz.Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz.Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Brazilian Multicity Study Group on Drug Misuse.
Resumen en ingles
Person who inject illicit substances have an important role in HIV-1 blood and sexual transmission
and together with person who uses heavy non-injecting drugs may have less than
optimal adherence to anti-retroviral treatment and eventually could transmit resistant HIV
variants. Unfortunately, molecular biology data on such key population remain fragmentary
in most low and middle-income countries. The aim of the present study was to assess HIV
infection rates, evaluate HIV-1 genetic diversity, drug resistance, and to identify HIV transmission
clusters in heavy drug users (DUs). For this purpose, DUs were recruited in the context
of a Respondent-Driven Sampling (RDS) study in different Brazilian cities during 2009.
Overall, 2,812 individuals were tested for HIV, and 168 (6%) of them were positive, of which
19 (11.3%) were classified as recent seroconverters, corresponding to an estimated incidence
rate of 1.58%/year (95% CI 0.92–2.43%). Neighbor joining phylogenetic trees from
env and pol regions and bootscan analyses were employed to subtype the virus from132
HIV-1-infected individuals. HIV-1 subtype B was prevalent in most of the cities under analysis,
followed by BF recombinants (9%-35%). HIV-1 subtype C was the most prevalent in
Curitiba (46%) and Itajaí (86%) and was also detected in Brasília (9%) and Campo Grande
(20%). Pure HIV-1F infections were detected in Rio de Janeiro (9%), Recife (6%), Salvador
(6%) and Brasília (9%). Clusters of HIV transmission were assessed by Maximum likelihood
analyses and were cross-compared with the RDS network structure. Drug resistance mutations
were verified in 12.2% of DUs. Our findings reinforce the importance of the permanent
HIV-1 surveillance in distinct Brazilian cities due to viral resistance and increasing subtype
heterogeneity all over Brazil, with relevant implications in terms of treatment monitoring, prophylaxis
and vaccine development.
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