Epidemiologia molecular do vírus da imunodeficiência humana do tipo i no estado de Roraima

Abstract

The study of genetic diversity and detection of mutations to antiretroviral therapy is crucial for epidemiological surveillance of HIV-1, because it can provide information about the viral biology, guiding policies for prevention and treatment. From 2007 to 2012, Roraima ranks among the top five states with the highest incidence rates, from 2008 to 2010 occupied the second position. Likewise, the capital of Boa Vista in 2007 until 2011 also ranks among the five capitals with highest incidence rate. Data related to HIV-1 genotyping or related data on resistance mutations in the state are of fundamental importance to understand the local epidemic. In this context, this work has identified circulating HIV-1 subtypes; evaluated primary and secondary resistance in patients with HIV and described the frequency of the CCR5 gene polymorphism (rs333) in patients treated at the Central Laboratory of the State of Roraima / HIV Lab. A total of 121 samples were collected and regions of the proviral DNA of RT / PR, integrase and envelope genes were amplified and subjected to nucleotide sequencing. Human genomic DNA was only amplified and compared by electrophoresis. Demographic data were analyzed using descriptive statistics, while the genetic data were evaluated by several bioinformatics tools for analyzing: resistance, genotyping, phylogenetic reconstruction and viral tropism. A frequency of 9.17% for the human CCR5 genotype / CCR5Δ32 and 90.83% in relation to CCR5 / CCR5 was observed. With respect to the viral subtype, the highest prevalence was found for subtype B (Integrase) and Pol gene, followed by subtype F1 and recombinant forms of B / F (Integrase) and B / D (Pol). Only one case of primary resistance was detected (7.69%), however, in patients receiving therapy this number achieved 30,7%. Phylogenetic analysis showed that the Roraima's samples grouped into different clades with Uruguayan, Brazilian, Venezuelan and Guyanese samples, which probably reflects distinct events of viral entry. Around 25% of X4 samples were found, which affects the possibility of administering the fusion Maraviroc inhibitors for these patients. We believe that the data obtained in this study will contribute to a better understanding of the HIV / AIDS epidemiology of in the state of Roraima. Besides the scientific return, we believe that the results will indirectly contribute to improving patient care in this population