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HIV‑1 MOLECULAR DIVERSITY IN BRAZIL UNVEILED BY 10 YEARS OF SAMPLING BY THE NATIONAL GENOTYPING NETWORK
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Abstract
HIV-1 has diversified into several subtypes and recombinant forms that are heterogeneously spread
around the world. Understanding the distribution of viral variants and their temporal dynamics can
help to design vaccines and monitor changes in viral transmission patterns. Brazil has one of the
largest HIV-1 epidemics in the western-world and the molecular features of the virus circulating in the
country are still not completely known. Over 50,000 partial HIV-1 genomes sampled between 2008
and 2017 by the Brazilian genotyping network (RENAGENO) were analyzed. Sequences were filtered
by quality, duplicate sequences per patient were removed and subtyping was performed with online
tools and molecular phylogeny. Association between patients’ demographic data and subtypes were
performed by calculating the relative risk in a multinomial analysis and trends in subtype prevalence
were tested by Pearson correlation. HIV-1B was found to be the most prevalent subtype throughout
the country except in the south, where HIV-1C prevails. An increasing trend in the proportion of
HIV-1C and F1 was observed in several regions of the country, while HIV-1B tended to decrease. Men
and highly educated individuals were more frequently infected by HIV-1B and non-B variants were
more prevalent among women with lower education. Our results suggest that socio-demographic
factors partially segregate HIV-1 diversity in Brazil while shaping viral transmission networks.
Historical events could explain a preferential circulation of HIV-1B among men who have sex with
men (MSM) and non-B variants among heterosexual individuals. In view of an increasing male/female
ratio of AIDS cases in Brazil in the last 10–15 years, the decrease of HIV-1B prevalence is surprising and
suggests a greater penetrance of non-B subtypes in MSM transmission chains.
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