Dynamics and features of transmission clusters of HIV-1 subtypes in the state of São Paulo, Brazil

• Main Authors: Victor Pimentel (Author), Andrea Pineda-Peña (Author), Cruz S. Sebastião (Author), João L. de Paula (Author), Cintia M. Ahagon (Author), Marta Pingarilho (Author), M. Rosário O. Martins (Author), Luana P. O. Coelho (Author), Elaine M. Matsuda (Author), Daniela Alves (Author), Ana B. Abecasis (Author), Luís F. M. Brígido (Author)
• Format: Book
• Published: Frontiers Media S.A., 2024-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

BackgroundMolecular epidemiology techniques allow us to track the HIV-1 transmission dynamics. Herein, we combined genetic, clinical and epidemiological data collected during routine clinical treatment to evaluate the dynamics and characteristics of transmission clusters of the most prevalent HIV-1 subtypes in the state of São Paulo, Brazil.MethodsThis was a cross-sectional study conducted with 2,518 persons living with HIV (PLWH) from 53 cities in São Paulo state between Jan 2004 to Feb 2015. The phylogenetic tree of protease/reverse transcriptase (PR/RT) regions was reconstructed by PhyML and ClusterPicker used to infer the transmission clusters based on Shimodaira-Hasegawa (SH) greater than 90% (phylogenetic support) and genetic distance less than 6%.ResultsOf a total of 2,518 sequences, 2,260 were pure subtypes at the PR/RT region, being B (88%), F1 (8.1%), and C (4%). About 21.2% were naïve with a transmitted drug resistance (TDR) rate of 11.8%. A total of 414 (18.3%) of the sequences clustered. These clusters were less evident in subtype B (17.7%) and F1 (15.1%) than in subtype C (40.2%). Clustered sequences were from PLWH at least 5 years younger than non-clustered among subtypes B (p < 0.001) and C (p = 0.037). Men who have sex with men (MSM) predominated the cluster in subtype B (51%), C (85.7%), and F1 (63.6%; p < 0.05). The TDR rate in clustered patients was 15.4, 13.6, and 3.1% for subtypes B, F1, and C, respectively. Most of the infections in subtypes B (80%), C (64%), and F1 (59%) occurred within the state of São Paulo. The metropolitan area of São Paulo presented a high level of endogenous clustering for subtypes B and C. The São Paulo city had 46% endogenous clusters of subtype C.ConclusionOur findings showed that MSM, antiretroviral therapy in Treatment-Naive (ART-naïve) patients, and HIV1-C, played an important role in the HIV epidemic in the São Paulo state. Further studies in transmission clusters are needed to guide the prevention intervention.

Item Description

2296-2565
10.3389/fpubh.2024.1384512