Author(s):
Bártolo, Inês ; Zakovic, Susana ; Martin, Francisco ; Palladino, Claudia ; Carvalho, Patrícia ; Camacho, Ricardo ; Thamm, Sven ; Clemente, Sofia ; Taveira, Nuno
Date: 2014
Persistent ID: http://hdl.handle.net/10400.26/8231
Origin: Egas Moniz - Cooperativa de Ensino Superior, CRL
Project/scholarship:
info:eu-repo/grantAgreement/FCT/3599-PPCDT/PTDC%2FSAU-EPI%2F122400%2F2010/PT;
info:eu-repo/grantAgreement/FCT/SFRH/SFRH%2FBPD%2F76225%2F2011/PT;
info:eu-repo/grantAgreement/FCT/SFRH/SFRH%2FBD%2F87488%2F2012/PT;
info:eu-repo/grantAgreement/FCT/SFRH/SFRH%2FBPD%2F77448%2F2011/PT;
info:eu-repo/grantAgreement/FCT/3599-PPCDT/PTDC%2FSAU-FAR%2F115290%2F2009/PT;
info:eu-repo/grantAgreement/FCT/SFRH/SFRH%2FBPD%2F76225%2F2011/PT;
info:eu-repo/grantAgreement/FCT/SFRH/SFRH%2FBD%2F87488%2F2012/PT;
Subject(s): HIV-1; Angola
Description
This is an openaccess article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
"Objectives: To assess HIV-1 diversity, transmission dynamics and prevalence of transmitted drug resistance (TDR) in Angola, five years after ART scale-up. Methods: Population sequencing of the pol gene was performed on 139 plasma samples collected in 2009 from drug-naive HIV-1 infected individuals living in Luanda. HIV-1 subtypes were determined using phylogenetic analysis. Drug resistance mutations were identified using the Calibrated Population Resistance Tool (CPR). Transmission networks were determined using phylogenetic analysis of all Angolan sequences present in the databases. Evolutionary trends were determined by comparison with a similar survey performed in 2001. Results: 47.1% of the viruses were pure subtypes (all except B), 47.1% were recombinants and 5.8% were untypable. The prevalence of subtype A decreased significantly from 2001 to 2009 (40.0% to 10.8%, P50.0019) while the prevalence of unique recombinant forms (URFs) increased.2-fold (40.0% to 83.1%, P,0.0001). The most frequent URFs comprised untypable sequences with subtypes H (U/H, n57, 10.8%), A (U/A, n56, 9.2%) and G (G/U, n54, 6.2%). Newly identified U/H recombinants formed a highly supported monophyletic cluster suggesting a local and common origin. TDR mutation K103N was found in one (0.7%) patient (1.6% in 2001). Out of the 364 sequences sampled for transmission network analysis, 130 (35.7%) were part of a transmission network. Forty eight transmission clusters were identified; the majority (56.3%) comprised sequences sampled in 2008–2010 in Luanda which is consistent with a locally fuelled epidemic. Very low genetic distance was found in 27 transmission pairs sampled in the same year, suggesting recent transmission events. Conclusions: Transmission of drug resistant strains was still negligible in Luanda in 2009, five years after the scale-up of ART. The dominance of small and recent transmission clusters and the emergence of new URFs are consistent with a rising HIV-1 epidemics mainly driven by heterosexual transmission."
This work was supported by Fundação para a Ciência e Tecnologia (FCT) http://www.fct. pt), Portugal, (grants ‘‘PTDC/SAU-FAR/115290/ 2009’’ and ‘‘PTDC/SAU-EPI/122400/2010’’), and by Collaborative HIV and Anti-HIV Drug Resistance Network (CHAIN), from the European Union. Inês Bártolo was supported by a post-doc fellowship (SFRH/BPD/76225/2011) from Fundação para a Ciência e Tecnologia (FCT), Portugal. Suzana Zakovic was supported by a European Union studentship from the Erasmus Mundus Masters in Forensic Sciences (http://forensicerasmusmundus. blogs.lincoln.ac.uk/). Francisco Martin was supported by a PhD fellowship (SFRH/BD/87488/2012) from Fundação para a Ciência e Tecnologia (FCT), Portugal. Claudia Palladino was supported by a post-doc fellowship (SFRH/BPD/77448/2011) from Fundação para a Ciência e Tecnologia (FCT), Portugal. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
