Perfil de mutações de resistência antirretroviral em isolados do hiv-1 circulantes na Bahia e no nordeste do Brasil entre os anos 2008 e 2017

Abstract

The development of antiretroviral resistance mutations (DRMs) is the main cause of therapeutic failure in people living with HIV and AIDS (PLWHA). Therefore, monitoring these mutations is the primary strategy to minimize potential harm to therapy and the clinical condition of PLWHA in adherence. Brazil is a country with a vast territory, exhibiting diverse patterns of HIV-1 genotypes and drug resistance mutations (DRMs) across its different geographical regions. Despite this diversity, knowledge about circulating DRMs remains extremely scarce in regions such as the Northeast, despite the epidemiological and public health significance of the HIV/aids epidemic. Thus, this study aimed to identify possible variations that this region presentes in comparison to Bahia state, characterizing the representational potential of this state for the region. We analyzed 7,096 partial HIV pol gene sequences from samples collected between 2008 and 2017 across the Northeast region, considering only the state of Bahia (N = 1,429; 20.13%). Mutations were identified using the Stanford HIVdb Program, and the resulting data were analyzed, considering sociodemographic factors and viral subtypes associated with each analyzed sequence. Overall, we identified DRM frequencies in 83.20% (N = 5,904) of sequences in the Northeast and 79.77% (N = 1,140) in Bahia, as the number of genotyped sequences increased each year. The most frequently identified mutations (especially M184V, K103N, and M41L) were similar between the Northeast and Bahia, although they followed different magnitudes, except for V82A, I54V, and K219Q, which were frequently found in the Northeast but not in Bahia. This state had the third-highest number of sequences, yet relatively few of these presented DRMs. Although this scenario provides valuable information for the literature and a better understanding of resistance dynamics in genotyped individuals in the Northeast and Bahia, limitations in access to and lack of reported data should be considered for the analyses performed. Additionally, statistical analyses need to be further detailed to make more robust inferences regarding whether Bahia can be considered representative of the Northeast during the analyzed period.