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HIV-1 GENETIC DIVERSITY AND TRANSMITTED DRUG RESISTANCE MUTATIONS AMONG PATIENTS FROM THE NORTH, CENTRAL AND SOUTH REGIONS OF ANGOLA
Affilliation
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil / Universidade Agostinho Neto. Luanda, Angola.
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.
São Lucas Medical Center. Kifangondo, Angola.
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 Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
São Lucas Medical Center. Kifangondo, Angola.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Abstract
Background: Angola presents a very complex HIV-1 epidemic characterized by the co-circulation of several HIV-1 group M
subtypes, intersubtype recombinants and unclassified (U) variants. The viral diversity outside the major metropolitan
regions (Luanda and Cabinda) and the prevalence of transmitted drug resistance mutations (DRM) since the introduction of
HAART in 2004, however, has been barely studied.
Methods: One hundred and one individuals from the Central (n = 44), North (n = 35), and South (n = 22) regions of Angola
were diagnosed as HIV-1 positive and had their blood collected between 2008 and 2010, at one of the National Referral
Centers for HIV diagnosis, the Kifangondo Medical Center, located in the border between the Luanda and Bengo provinces.
Angolan samples were genotyped based on phylogenetic and bootscanning analyses of the pol (PR/RT) gene and their drug
resistance profile was analyzed.
Results: Among the 101 samples analyzed, 51% clustered within a pure group M subtype, 42% were classified as
intersubtype recombinants, and 7% were denoted as U. We observed an important variation in the prevalence of different
HIV-1 genetic variants among country regions, with high frequency of subtype F1 in the North (20%), intersubtype
recombinants in the Central (42%), and subtype C in the South (45%). Statistically significant difference in HIV-1 clade
distribution was only observed in subtype C prevalence between North vs South (p = 0.0005) and Central vs South
(p = 0.0012) regions. DRM to NRTI and/or NNRTI were detected in 16.3% of patients analyzed.
Conclusions: These results demonstrate a heterogeneous distribution of HIV-1 genetic variants across different regions in
Angola and also revealed an unexpected high frequency of DRM to RT inhibitors in patients that have reported no
antiretroviral usage, which may decrease the efficiency of the standard first-line antiretroviral regimens currently used in the
country.
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