The Brazilian Journal of Infectious Diseases The Brazilian Journal of Infectious Diseases
Braz J Infect Dis 2017;21:234-9 - Vol. 21 Num.3 DOI: 10.1016/j.bjid.2017.02.006
Original article
Geolocalization of HIV-1 subtypes and resistance mutations of patients failing antiretroviral therapy in Salvador – Brazil
Antonio Walter de Oliveira Filho, Carlos Brites,
LAPI - Laboratório de Pesquisa em Infectologia, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil
Received 30 June 2016, Accepted 22 February 2017
Abstract
Background

Geographical distribution of HIV variants is an important way to understand the circulation and spread of such viral strains.

Objectives

To evaluate the spatial distribution of HIV-1 variants in patients failing antiretroviral therapy, in Salvador, Brazil.

Methods

We performed a cross-sectional evaluation of HIV resistance test reports of patients who underwent genotyping tests in a referral center in Salvador, Brazil, for the years 2008–2014. The laboratory database contains around 2500 resistance reports of patients failing antiretroviral therapy. Genotypic tests were performed by sequencing of HIV-1 POL region (TrueGene, Siemens). We assessed HIV-1 resistance mutations and subtype, as well as residential address, age, and gender of patients.

Results

We evaluated 1300 reports, 772 (59.4%) of them from male patients. As expected, subtype B predominated (79%) followed by subtypes F1 (6.7%) and BF (6.5%). The most frequent mutations in HIV-1 reverse transcriptase were 184V (79.1%), 41L (33.5%), 67N (30.4%), 103N (42.4%), and 108I (11.1%). Most frequent mutations in HIV-1 protease were 63P (52.4%), 36I (47.9%), 15 V (33.0%), 62 V (28.1%) and 13 V (25.8%). Some mutations (41L, 215Y, 210W) were significantly more frequent among men. We detected a significantly higher accumulation of 103N mutation in specific areas of Salvador. We identified a more restricted circulation pattern for subtype FB (more frequent in some regions), and F1 (almost absent in a specific region).

Conclusion

Our results suggest that specific subtypes/resistance mutations present a distinct frequency rate in specific areas of Salvador, probably due to a restricted circulation pattern. This trend to clustering was observed in regions covered by AIDS referral centers, suggesting that pattern of care for such patients can interfere in virological outcomes.

Keywords
HIV-1, Resistance mutations, Brazil, Geolocalization
Braz J Infect Dis 2017;21:234-9 - Vol. 21 Num.3 DOI: 10.1016/j.bjid.2017.02.006