Frequência de dupla infecção entre os subtipos B e F1 do HIV-1 em homens brasileiros que fazem sexo com homens
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Data
2012-07-25
Autores
Oliveira, Ana Carolina Soares de [UNIFESP]
Orientadores
Al-Sanabani. Sabri Saeed Mohamed Ahmed [UNIFESP]
Tipo
Tese de doutorado
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Introdução: Como vários estudos sobre vacinação contra HIV estão em progresso, é importante compreender a frequência na qual ocorrem co/superinfecções intra ou intersubtipos em grupos de alto risco. Esse conhecimento auxiliaria no
desenvolvimento de programas de prevenção futuros. Nesse estudo transversal, relatamos a frequência de coinfecção entre os subtipos B e F1 em uma cohorte clínica de 41 homens que fazem sexo com homens (HSH), recém infectados com HIV-1, em São Paulo, Brasil. Metodologia: O DNA proviral do HIV-1 foi isolado a partir de leucócitos de sangue periférico de sujeitos polimorfonucleares (PMNs), que foram obtidos no
momento da inscrição. Cada indivíduo era conhecidamente infectado por um vírus do subtipo B, conforme determinado em estudo anterior. Um pequeno fragmento do gene da integrase (nucleotídeo 4255-4478 do HXB2) foi amplificado por PCR utilizando primers específicos para F1. Os resultados da PCR foram confirmados por análise filogenética. Os dados de carga viral (VL) foram inferidos a partir dos prontuários de cada paciente. Resultados: Das 41 amostras estudadas, 5 apresentaram DNA proviral do subtipo F1, O que representa uma taxa de 12,2% de coinfecção. A comparação entre os valores de carga viral entre os coinfectados e os infectados apenas pelo subtipo B não foi estatisticamente diferente (p> 0,16). Nos indivíduos com infecção dupla a carga viral mediana foi de 5,3 x 104 cópias/mL (intervalo de <400 – 12,5 x 104 cópias/mL), e nos indivíduos infectados apenas pelo subtipo B a carga viral mediana foi de 4,3 x 104 cópias/mL (intervalo de <400 – 39,9 x 104 cópias/mL). Conclusão: Esse estudo indicou que a coinfecção entre os subtipos B e F1 ocorre com frequência na população de homens que fazem sexo com homens, HIV-1 positivos, como sugerido por um grande número de vírus recombinantes BF1 relatados no Brasil. Na ausência de uma vacina eficaz contra o HIV-1, o teste para co/superinfecção e a implantação de medidas eficazes nos grupos de risco podem ajudar a reduzir a exposição viral, a transmissão e a recombinação.
Introduction: Because various HIV vaccination studies are in progress, it is important to understand how often inter- and intra-subtype co/superinfection occurs in different HIV-infected high-risk groups. This knowledge would aid in the development of future prevention programs. In this cross-sectional study, we report the frequency of subtype B and F1 co-infection in a clinical group of 41 recently HIV-1 infected men who have sex with men (MSM) in São Paulo, Brazil. Methodology: Proviral HIV-1 DNA was isolated from subject's peripheral blood polymorphonuclear leukocytes that were obtained at the time of enrollment. Each subject was known to be infected with a subtype B virus as determined in a previous study. A small fragment of the integrase gene (nucleotide 4255-4478 of HXB2) was amplified by nested polymerase chain reaction (PCR) using subclade F1 specific primers. The PCR results were further confirmed by phylogenetic analysis. Viral load (VL) data were extrapolated from the medical records of each patient. Results: In the 41 samples from MSM who were recently infected with subtype B virus, in five patients it was possible to detect subclade F1 proviral DNA, which represents a co-infection rate of 12.2%. In subjects with dual infection, the median VL was 5.3 X 104 copies/ML, whereas in MSM that were infected with only subtype B virus the median VL was 3.8 X 104 copies/ML (p > 0.8). Conclusions: This study indicated that subtype B and F1 co-infection occurs frequently within the HIV-positive MSM population as suggested by large number of BF1 recombinant viruses reported in Brazil. In the absence of an effective HIV-1 vaccine, testing for co/superinfections and the implementation of powerful measures in both MSM and other HIV risk groups may help to reduce viral exposure, transmission, and recombination.
Introduction: Because various HIV vaccination studies are in progress, it is important to understand how often inter- and intra-subtype co/superinfection occurs in different HIV-infected high-risk groups. This knowledge would aid in the development of future prevention programs. In this cross-sectional study, we report the frequency of subtype B and F1 co-infection in a clinical group of 41 recently HIV-1 infected men who have sex with men (MSM) in São Paulo, Brazil. Methodology: Proviral HIV-1 DNA was isolated from subject's peripheral blood polymorphonuclear leukocytes that were obtained at the time of enrollment. Each subject was known to be infected with a subtype B virus as determined in a previous study. A small fragment of the integrase gene (nucleotide 4255-4478 of HXB2) was amplified by nested polymerase chain reaction (PCR) using subclade F1 specific primers. The PCR results were further confirmed by phylogenetic analysis. Viral load (VL) data were extrapolated from the medical records of each patient. Results: In the 41 samples from MSM who were recently infected with subtype B virus, in five patients it was possible to detect subclade F1 proviral DNA, which represents a co-infection rate of 12.2%. In subjects with dual infection, the median VL was 5.3 X 104 copies/ML, whereas in MSM that were infected with only subtype B virus the median VL was 3.8 X 104 copies/ML (p > 0.8). Conclusions: This study indicated that subtype B and F1 co-infection occurs frequently within the HIV-positive MSM population as suggested by large number of BF1 recombinant viruses reported in Brazil. In the absence of an effective HIV-1 vaccine, testing for co/superinfections and the implementation of powerful measures in both MSM and other HIV risk groups may help to reduce viral exposure, transmission, and recombination.
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Citação
OLIVEIRA, Ana Carolina Soares de. Frequência de dupla infecção entre os subtipos B e F1 do HIV-1 em homens brasileiros que fazem sexo com homens. São Paulo, 2012. 80 f. Dissertação (Mestrado em Medicina Translacional) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2012.