Análise da diversidade genética do HIV-1 e da prevalência de mutações de resistência aos antirretrovirais em uma população de crianças e adolescentes do estado do Rio de Janeiro / Analysis of HIV-1 genetic diversity and prevalence of resistance mutations to antiretroviral drugs in a population of children and adolescents from Rio de Janeiro state
The introduction of highly active antiretroviral therapy (HAART) has reducedmorbidity and mortality rates in HIV-1-infected children, however, the emergence ofdrug-resistant virus may limit the treatment efficacy. The alternative is the adoption ofrescue therapies, however, the options for childrenwho do not respond to HAARTremain limited and there are few studies on the prevalence of drug resistancemutations to these drugs.[...] The aim of this study was to evaluate the genetic diversity of HIV-1, the prevalence of acquired (DRM) and transmitted (TDRM) antiretroviral resistancemutations for Nucleos(t)ide (NRTI) and Non-Nucleoside (NNRTI) ReverseTranscriptase Inhibitors and Protease Inhibitors (IP), in addition to TDRM for Integrase(IIN) and Fusion (IF) Inhibitors and viral tropism in the prediatric population from Riode Janeiro Brazil. To this end, 276 nucleotide sequences of the protease and reversetranscriptase regions obtained from RENAGENO from 2008 to 2012 and stored in theLaboratory of AIDS and Molecular Immunology database were analyzed. Thesequences were classified into two groups, treatment-naive (VT, n = 97) and treatedand failing HAART (n = 179) individuals. In a subsets of each group were performedviral RNA extraction, amplification and sequencing of the integrase (VT n = 24, n = 48multiexperienced), gp41 (VT = 14, multiexperienced = 26) and C2V3 (VT n = 7,multiexperienced n = 26) regions. The subtypes were determined by REGA andconfirmed by phylogenetic and recombinationanalysis. The TDRM and DRM weredetermined by algorithms available in the HIVDrug Resistance Database. The viraltropism was determined by geno2pheno tool and 11/25 rule.