Dinâmica temporal, subtipos e caracteristicas epidemiológicas da infecção pelo hiv-1, Brasil Central / Dinamic temporal, subtypes and epidemiological characteristics of hiv1 infection, Central Brazil

O objetivo deste estudo foi identificar os principais subtipos de HIV-1 circulantes no Mato Grosso do Sul (MS), Brasil Central. Métodos: Trata-se de um estudo transversal de séries temporais com dados de laboratório e relato de doença, analisados por período de diagnóstico e variáveis sociodemográficas e clínicas. Resultados: Subtipo B HIV-1 predominou quando os períodos foram analisados (85,4% vs 85,3%). Além disso, foi detectado um aumento na frequência do subtipo C do HIV-1, mas nenhuma diferença significativa foi observada entre os dois períodos. Após análise univariada, a faixa etária entre 25 e 45 anos (p = 0,004) e o gênero masculino (p = 0,04) mostraram-se associados ao subtipo B HIV-1. Os achados relacionados à resistência do HIV-1 à ARV mostraram que 30,6% dos pacientes diagnosticados com AIDS entre 1985 e 2012, submetidos a testes de genotipagem (212), eram resistentes a mais de três classes de ARVs (MDR). Conclusões: Estudos sobre a diversidade genética, bem como o perfil de mutações de resistência no HIV-1, são ferramentas importantes para a reconstrução histórica de epidemias regionais, vigilância epidemiológica local e diretrizes de tratamento.

The objective of this study was to identify the major subtypes of HIV-1 circulating in Mato Grosso do Sul (MS), Central Brazil. Methods:This is a cross-sectional study of time series with data from laboratory and disease report, analyzed by period of diagnosis and sociodemographic and clinical variables. Results: Subtype B HIV-1 predominated when periods were analyzed (85.4% vs 85.3%). In addition, an increase in the frequency of HIV-1 subtype C was detected, but no significant difference was seen between the two periods. After univariate analysis, the age range between 25 and 45 years (p = 0.004) and the masculine gender (p = 0.04) were found to be associated with subtype B HIV-1. The findings related to the resistance of HIV-1 to ARV showed that 30.6% of the investigated patients diagnosed AIDS between 1985 and 2012 who underwent genotyping tests (212) were resistant to more than three ARV classes (MDR). Conclusions: Studies on the genetic diversity, as well as the profile of resistance mutations in HIV-1, are important tools for both the historical reconstruction of regional epidemics and local epidemiological surveillance and treatment guidelines.

HIV type 1 molecular epidemiology in pol and gp41 genes among naive patients from Mato Grosso do Sul State, central western Brazil.

Antiretroviral naive patients (n=49) were recruited in central western Brazil (Campo Grande City/Mato Grosso do Sul State, located across the Bolivia and Paraguay borders). HIV-1 protease (PR), reverse transcriptase (RT), and env gp41 HR1 fragments were sequenced. Genetic diversity was analyzed by REGA/phylogenetic analyses. Intersubtype recombinants were identified by SimPlot/phylogenetic trees. PR/RT resistance was analyzed by Calibrated Population Resistance/Stanford databases. T-20 resistance in gp41 was assessed by Stanford, Los Alamos, and other sources. Of HIV-1 subtypes 65.3% were B(PR)B(RT), 10.2% were C(PR)C(RT), and 8.2% were F1(PR)F1(RT). Intersubtype recombinants were 16.3%: four B/F1 and four B/C (two were "CRF31_BC-like"). The Pol-RT V75M mutation was detected in two homosexual partners; one patient had the T215S revertant mutation. T-20/gp41 resistance mutations were L44M (n=2) and V38A (n=1). The high percentage of non-B isolates (∼35%) highlights the importance of molecular surveillance studies in settings distant from the origin of the epidemic. Our data help elaborate the molecular epidemiological map of HIV-1 in Brazil.

Molecular characteristics of HIV type 1 infection among prisoners from Central Western Brazil.

Abstract This study among antiretroviral-experienced prisoners from central western Brazil investigated mutations associated with secondary resistance to nucleoside/nonnucleoside reverse transcriptase inhibitors (NRTI/NNRTI), protease inhibitors (Stanford HIV-1 Resistance/International Aids Society Databases), and HIV-1 subtypes (REGA/phylogenetic analyses/SimPlot). Twenty-seven prisoners from three prisons (16 males and four females from Mato Grosso do Sul State and seven males from Goiás State) had HIV-1 protease and reverse transcriptase fragments sequenced after nested PCR. Median age was 35 years. Seven males and two females were intravenous drug users, three males referred homosexual practice. Resistance mutations were present in 37% (10/27): NRTI+NNRTI mutations (n=5), NRTI mutations (n=3), multidrug-resistant mutations (n=2). Subtype B (48%), subtype C (11%), B/F1, B/C, and F1/B/C recombinants (40.7%) were detected. Possible intraprison transmissions were identified: two intravenous drug user females (subtype C); two clusters among homosexual males (subtype B and B/F1). High resistance rate and possible intraprison transmission highlight the need for improved prevention, counseling, and treatment strategies for prisoners.

Seroprevalence of hepatitis B virus infection and associated factors among prison inmates in state of Mato Grosso do Sul, Brazil.

INTRODUCTION: This study aimed to estimate the prevalence of HBV infection and associated factors among prison inmates in Campo Grande, MS. METHODS: A total of 408 individuals were interviewed regarding sociodemographic characteristics, associated factors and HBV vaccination using a standardized questionnaire. Blood samples were collected from all participants and serological markers for HBV were detected by enzyme-linked immunosorbent assay. Hepatitis B surface antigen (HBsAg) and/or antibodies against hepatitis B core antigen (anti-HBc) positive samples were tested for HBV-DNA by polymerase chain reaction. RESULTS: The overall prevalence of HBV infection was 17.9% (95%CI: 14.4-22.0). The HBsAg carrier rate was 0.5%; 56 (13.7%) individuals had been infected and developed natural immunity and 15 (3.7%) were positive for anti-HBc only. Ninety eight (24%) prisoners had only anti-HBs, suggesting that they had low vaccine coverage. An occult HBV infection rate of 0% was verified among anti-HBc-positive individuals. Multivariate analysis of associated factors showed that age > 35 years-old, low schooling level and illicit drug use are significantly associated with HBV infection. CONCLUSIONS: Analysis of the data showed HBV infection prevalence similar or slightly lower than that reported in other of Brazilian prisons. Independent predictors of HBV infection in this population include older age, low schooling level and illicit drug use.

Seroprevalence of hepatitis B virus infection and associated factors among prison inmates in state of Mato Grosso do Sul, Brazil / Soroprevalência e fatores associados à infecção pelo vírus da hepatite B em população encarcerada no estado do Mato Grosso do Sul, Brasil

INTRODUCTION: This study aimed to estimate the prevalence of HBV infection and associated factors among prison inmates in Campo Grande, MS. METHODS: A total of 408 individuals were interviewed regarding sociodemographic characteristics, associated factors and HBV vaccination using a standardized questionnaire. Blood samples were collected from all participants and serological markers for HBV were detected by enzyme-linked immunosorbent assay. Hepatitis B surface antigen (HBsAg) and/or antibodies against hepatitis B core antigen (anti-HBc) positive samples were tested for HBV-DNA by polymerase chain reaction. RESULTS: The overall prevalence of HBV infection was 17.9 percent (95 percentCI: 14.4-22.0). The HBsAg carrier rate was 0.5 percent; 56 (13.7 percent) individuals had been infected and developed natural immunity and 15 (3.7 percent) were positive for anti-HBc only. Ninety eight (24 percent) prisoners had only anti-HBs, suggesting that they had low vaccine coverage. An occult HBV infection rate of 0 percent was verified among anti-HBc-positive individuals. Multivariate analysis of associated factors showed that age > 35 years-old, low schooling level and illicit drug use are significantly associated with HBV infection. CONCLUSIONS: Analysis of the data showed HBV infection prevalence similar or slightly lower than that reported in other of Brazilian prisons. Independent predictors of HBV infection in this population include older age, low schooling level and illicit drug use.

INTRODUÇÃO: O presente estudo teve como objetivo investigar a prevalência da infecção pelo HBV e os fatores associados a esta infecção em população encarcerada de Campo Grande, MS. MÉTODOS: Quatrocentos e oito encarcerados, provenientes das populações encarceradas do Instituto Penal de Campo Grande, Presídio de Segurança Máxima e Presídio Feminino Irmã Irma Zorzi, foram entrevistados sobre dados sociodemográficos e fatores associados à infecção pelo HBV. A seguir foram coletadas amostras sanguíneas para detecção dos marcadores HBsAg, anti-HBs e anti-HBc total por ensaio imunoenzimático. O HBV-DNA foi detectado pela reação em cadeia da polimerase nas amostras HBsAg e anti-HBc reagentes. RESULTADOS: A prevalência global para infecção pelo HBV foi de 17,9 por cento (IC 95 por cento: 14,4-22,0), 13,7 por cento (56/408) para o anti-HBc total associado ao anti-HBs e em 15 (3,7 por cento) indivíduos foi detectada a presença do anti-HBc isolado. HBsAg foi encontrado em 0,5 por cento (2/408) dos indivíduos estudados, evidenciando uma baixa prevalência de casos crônicos. Em 24 por cento (98/408) dos indivíduos, verificou-se positividade isolada ao marcador anti-HBs, sugerindo baixa cobertura vacinal ao HBV. Após análise multivariada, ter idade maior que 35 anos, baixo nível de escolaridade e uso de droga ilícita permaneceram associados significativamente à infecção pelo HBV. CONCLUSÕES: A prevalência da infecção pelo HBV encontrada foi similar às reportadas em outros estudos conduzidos em populações encarceradas do Brasil. Os fatores de risco associados a esta infecção foram aumento da idade, baixo nível de escolaridade e uso de droga ilícita.