1. Prevalence and resistance mutations of non-B HIV-1 subtypes among immigrants in Southern Spain along the decade 2000-2010
- Author
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Felipe Fernández-Cuenca, Beatriz de Felipe, Luis F. López-Cortés, Alejandro Vallejo, Pompeyo Viciana, Francisco J. Martinez-Fernandez, Pilar Pérez-Romero, Manuel Leal, Rosario Mata, María Abad-Fernández, Mónica Trastoy, [de Felipe,B, Pérez-Romero,P, Martinez-Fernandez,FJ, Trastoy,M, Mata,RC, López-Cortés,LF, Viciana,P] Infectious Diseases Service, IBIS, Hospital Univeritario Virgen del Rocio, Seville, Spain. [Abad-Fernández,M, Vallejo,A] Laboratory of Immunovirology, Infectious Diseases Service, Instituto Ramón y Cajal de Investigaciones Cientificas (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain.[Fernandez-Cuenca,F] Microbiology Service Hospital Virgen Macarena Seville, Spain. [Leal,M, Vallejo,A] Laboratory of Immunovirology, Infectious Diseases Service, IBIS, Virgen del Rocío University Hospital, Seville, Spain., and This study was supported in part by Fondo de Investigación Sanitaria (FIS) 07/0070, Redes Temáticas de Investigación Cooperativa en Salud (RETICS) Red de Investigación en SIDA (RIS) RD06/0006/0021 and RD/06/0006/0034, and Servicio Andaluz de Salud, Consejería de Salud 0407/2007.
- Subjects
Male ,Immigration ,Human immunodeficiency virus (HIV) ,HIV Infections ,Drug resistance ,resistance mutation ,medicine.disease_cause ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Mutación Missense ,HIV Protease ,Genotype ,Prevalence ,Cluster Analysis ,Phylogeny ,media_common ,Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings] ,Resistance mutation ,HIV Reverse Transcriptase ,Phenomena and Processes::Genetic Phenomena::Genetic Variation::Mutation::Mutation, Missense [Medical Subject Headings] ,Infectious Diseases ,Cohort ,Female ,Phenomena and Processes::Genetic Phenomena::Genotype [Medical Subject Headings] ,Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial::Drug Resistance, Viral [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Genetic Techniques::Sequence Analysis::Sequence Analysis, DNA [Medical Subject Headings] ,Adult ,Anti-HIV Agents ,media_common.quotation_subject ,Molecular Sequence Data ,Mutation, Missense ,Emigrants and Immigrants ,immigrant ,Biology ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Cluster Analysis [Medical Subject Headings] ,non-B HIV-1 subtypes ,lcsh:Infectious and parasitic diseases ,Virology ,Drug Resistance, Viral ,medicine ,Humans ,lcsh:RC109-216 ,Organisms::Viruses::RNA Viruses::Retroviridae::Lentivirus::Lentiviruses, Primate::HIV::HIV-1 [Medical Subject Headings] ,Resistance (ecology) ,Research ,Andalucía ,Sequence Analysis, DNA ,Emigrantes e Inmigrantes ,Spain ,Named Groups::Persons::Emigrants and Immigrants [Medical Subject Headings] ,Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings] ,HIV-1 - Abstract
Background Most of the non-B HIV-1 subtypes are predominant in Sub-Saharan Africa and India although they have been found worldwide. In the last decade, immigration from these areas has increased considerably in Spain. The objective of this study was to evaluate the prevalence of non-B subtypes circulating in a cohort of HIV-1-infected immigrants in Seville, Southern Spain and to identify drug resistance-associated mutations. Methods Complete protease and first 220 codons of the reverse transcriptase coding regions were amplified and sequenced by population sequencing. HIV-1 subtypes were determined using Stanford University Drug Resistance Database, and phylogenetic analysis was performed comparing multiple reported sequences. Drug resistance mutations were defined according to the International AIDS Society-USA. Results From 2000 to 2010 a total of 1,089 newly diagnosed HIV-1-infected patients were enrolled in our cohort. Of these, 121 were immigrants, of which 98 had ethical approval and informed consent to include in our study. Twenty-nine immigrants (29/98, 29.6%) were infected with non-B subtypes, of which 15/29 (51.7%) were CRF02-AG, mostly from Sub-Saharan Africa, and 2/29 (6.9%) were CRF01-AE from Eastern Europe. A, C, F, J and G subtypes from Eastern Europe, Central-South America and Sub-Saharan Africa were also present. Some others harboured recombinant forms CRF02-AG/CRF01-AE, CRF2-AG/G and F/B, B/C, and K/G, in PR and RT-coding regions. Patients infected with non-B subtypes showed a high frequency of minor protease inhibitor resistance mutations, M36I, L63P, and K20R/I. Only one patient, CRF02_AG, showed major resistance mutation L90M. Major RT inhibitor resistance mutations K70R and A98G were present in one patient with subtype G, L100I in one patient with CRF01_AE, and K103N in another patient with CRF01_AE. Three patients had other mutations such as V118I, E138A and V90I. Conclusions The circulation of non-B subtypes has significantly increased in Southern Spain during the last decade, with 29.6% prevalence, in association with demographic changes among immigrants. This could be an issue in the treatment and management of these patients. Resistance mutations have been detected in these patients with a prevalence of 7% among treatment-naïve patients compared with the 21% detected among patients under HAART or during treatment interruption.
- Published
- 2011