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CLINICAL, EPIDEMIOLOGICAL AND MOLECULAR FEATURES OF THE HIV-1 SUBTYPE C AND RECOMBINANT FORMS THAT ARE CIRCULATING IN THE CITY OF SÃO PAULO, BRAZIL
Affilliation
Universidade de São Paulo. Escola de Medicina. Departamento de Dermatologia. Laboratório de Dermatologia e Imunodeficiências. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Universidade de São Paulo. Escola de Medicina. Departamento de Dermatologia. Laboratório de Dermatologia e Imunodeficiências. São Paulo, SP, Brasil.
Universidade de São Paulo. Escola de Medicina. Departamento de Dermatologia. Laboratório de Dermatologia e Imunodeficiências. São Paulo, SP, Brasil / Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Universidade de São Paulo. Escola de Medicina. Departamento de Dermatologia. Laboratório de Dermatologia e Imunodeficiências. São Paulo, SP, Brasil.
Universidade de São Paulo. Escola de Medicina. Departamento de Dermatologia. Laboratório de Dermatologia e Imunodeficiências. São Paulo, SP, Brasil / Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brasil.
Abstract
Background: The city of Sao Paulo has the highest AIDS case rate, with nearly 60% in Brazil. Despite, several
studies involving molecular epidemiology, lack of data regarding a large cohort study has not been published from
this city.
Objectives: This study aimed to describe the HIV-1 subtypes, recombinant forms and drug resistance mutations,
according to subtype, with emphasis on subtype C and BC recombinants in the city of São Paulo, Brazil.
Study design: RNA was extracted from the plasma samples of 302 HIV-1-seropositive subjects, of which 211 were
drug-naive and 82 were exposed to ART. HIV-1 partial pol region sequences were used in phylogenetic analyses for
subtyping and identification of drug resistance mutations. The envelope gene of subtype C and BC samples was
also sequenced.
Results: From partial pol gene analyses, 239 samples (79.1%) were assigned as subtype B, 23 (7.6%) were F1,
16 (5.3%) were subtype C and 24 (8%) were mosaics (3 CRF28/CRF29-like). The subtype C and BC recombinants
were mainly identified in drug-naïve patients (72.7%) and the heterosexual risk exposure category (86.3%), whereas
for subtype B, these values were 69.9% and 57.3%, respectively (p = 0.97 and p = 0.015, respectively). An increasing
trend of subtype C and BC recombinants was observed (p < 0.01).
Conclusion: The HIV-1 subtype C and CRFs seem to have emerged over the last few years in the city of São Paulo,
principally among the heterosexual population. These findings may have an impact on preventive measures and
vaccine development in Brazil.
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