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Drug resistance mutations and HIV-1 subtypes within the Brazilian network for HIV-1 genotyping in patients failing antiretroviral therapy from Rio de Janeiro, Brazil: an update 2002-2006
Presented by José Carlos Couto-Fernandez, Brazil.
Couto-Fernandez J.C.1, Inocêncio L.A.2, Silva-de-Jesus C.1, Souza D.F.2, Simão M.B.G.2, Morgado M.G.1
1Oswaldo Cruz Foundation-Fiocruz, Immunology - Lab.of AIDS and Molecular Immunology, Rio de Janeiro, Brazil, 2Brazilian Ministry of Health-PNDST e AIDS, National Program of STD and AIDS, Brasília, Brazil
Objectives: To improve new antiretroviral therapy (ART) strategies in patients failing to respond to previous regimens, the Brazilian Ministry of Health has been applying the HIV-1 resistance genotyping test through the National Network for HIV-1 Genotyping (RENAGENO). In this study, we evaluated the distribution of HIV-1 subtypes and drug resistance mutations in Rio de Janeiro State, Brazil.
Methods: Between 2002 to 2006, blood samples from 1,796 HIV-1 patients from the whole Rio de Janeiro state were received for analysis. The ViroSeq Genotyping System (Celera Diagnostics, US) was used for the genotyping of viral resistance.
Results: The majority of the genotyped samples were classified as subtype B (89%), followed by subtype F (5%) and BF recombinant forms (4.5%). Subtype C was identified in 10 patients (0.61%), subtype D and the CRF02_AG in 4 patients (0.21% each), in addition to the CRF01_AE infecting one subject. The circulation of the CF and AF unique recombinant forms were detected in two patients (0.12% each). The drug resistance profile for the NRTI showed the M184V mutation as the most prevalent (67.8%), followed by TAMs T215F/Y (65.4%), M41L (50.5%) and D67N (46.7%). An increasing in the prevalence of the K103N NNRTI-associated mutation has been observed over the years. The major prevalent protease mutations were: L90M (26.5%), M46I (21.8%) and D30N (19%), in addition to the minor mutations L63P (72%), M36L (40.5%), L10I (43.4%) and A71V (39.4%).
Conclusions: The genetic data from the HIV-1 resistance genotyping have been extremely useful for molecular epidemiology studies in Rio de Janeiro. A clear association between HIV-1 subtypes and resistance mutations was observed. This is the first description of the CRF01_AE circulation in Brazil. In addition, the maintenance of HIV-1 genotyping programs has substantially contributed in the management of new ART in failure patients from Rio de Janeiro State, Brazil.
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