RESUMO
OBJECTIVE: There is scarce information about the molecular epidemiology of HIV-infection in Armenia (former USSR). The objective of this work was to estimate the distribution of HIV-1 subtypes in this country and get any information about HIV drug resistance in naÏve patients. DESIGN: A joint study involving 78 patients was carried out in Yerevan, Armenia and Moscow, Russia in 2009-2013. The cohort studies included mostly IDUs (28.2%) and heterosexuals (69.2%). RESULTS: The phylogenetic analyses based on population sequencing of partial pol gene found subtype A1 being the most prevalent (92.3%), followed by subtype B (3.9%). The HIV-1 tropism inferred from env V3-loop sequences was determined in 27 samples, among them R5-tropic viruses were found in 13 (48.1%) patients and X4- variants--in 14 (51.9%) patients. The prevalence of drug resistance in naïve patients was low (1.5%) with the only one mutation K219Q found. CONCLUSION: The composition and distribution of HIV-1 genetic variants in Armenia are evidently influenced by the Russian and other FSU countries epidemic, due to the significant volume of Armenian migrant/re-emigrant flows. Continued surveillance of HIV-1 circulating subtypes and drug resistance in Armenia is important for the proper management of HIV infection in this country.
Assuntos
Genótipo , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , HIV-1/classificação , HIV-1/genética , Adulto , Armênia/epidemiologia , Estudos de Coortes , Farmacorresistência Viral , Feminino , HIV-1/efeitos dos fármacos , HIV-1/isolamento & purificação , Heterossexualidade , Humanos , Masculino , Epidemiologia Molecular , Dados de Sequência Molecular , Moscou/epidemiologia , Mutação de Sentido Incorreto , Filogenia , Análise de Sequência de DNA , Homologia de Sequência , Abuso de Substâncias por Via Intravenosa/complicações , Produtos do Gene pol do Vírus da Imunodeficiência HumanaRESUMO
A molecular analysis of HIV-1 subtypes and recombinants circulating in cities in the Russian Far East was performed. The study included samples from 201 outpatients from Vladivostok, Khabarovsk, and Blagoveshchensk. In most parts of Russia, patients are infected with HIV-1 subtype A, known as the IDU-A variant. Subtype B, including the IDU-B variant, is rare in Russia but widespread in the Ukraine, and the CRF02_AG is prevalent in Central Asian countries and Siberia, Russia. One of the challenges of this study in the Far East was to determine whether the molecular landscape of HIV infection in this region is influenced by the bordering countries, including China and Japan, where a distinct set of HIV subtypes is circulating, such as B', C, and CRF01_AE. The distribution of HIV-1 genetic variants in the cities studied was as follows: subtype A (IDU-A), 55.7%; subtype B, 25.3% (IDU-B variant-24.3%); subtype C, 10.0%; CRF02_AG, 1.5%; and CRF63_02A1, 7.5%. A phylogenetic analysis confirmed the relationship of subtype A viruses with the IDU-A variant predominating in Ukraine, Russia and other former Soviet Union (FSU) countries, of subtype B viruses with IDU-B in the Ukraine and of CRF02_AG variants with variants in Uzbekistan, Russia, and other former USSR countries. Subtype C sequences were not uniform, and most clustered between each other and HIV-1 sequences originating from Africa; there was only one sample possibly related to Chinese variants. Thus, despite close cultural and commercial relationships among Russia, China, and Japan, the distribution of HIV-1 subtypes in the Russian Far East is still primarily influenced by contacts with the countries of the former USSR.