First report of HIV-1 subtypes C and H in Peru from HIV-infected patients receiving highly active anti-retroviral therapy (HAART)
C.A. Yabar, M. Acuña, P. Caballero
Instituto Nacional de Salud, Biotechnology and Molecular Biology Lab, Lima, Peru
Background: HIV-1 subtype B is the most frequent in Peru, however there is not data available about HIV-1 subtype infecting patients receiving HAART.
Methods: A group of 106 patients of the national HAART program with virologic failure were enrolled in the Instituto Nacional de Salud of Peru during March 2008 and July 2009. Then, viral RNA was extracted from plasma and PCR products of 1500 bp covering the pol region were amplified by RT-PCR, purified and fully sequenced. Consensus sequences were submitted to REGA software and HIVdb Genotypic Resistance Interpretation Algorithm, and then aligned by ClustalX v.2.0 to design the phylogenetic tree using MEGA version 4.1. Intragenic recombination breack point was analyzed by program SCUEAL (Subtype Classification by Evolutionary ALgo-rithms) for HIV.
Results: A total of 101 samples (83%) was successfully amplified. Analysis obtained from HIV db program showed resistance mutations to one or more antiretroviral drugs in 81% (n = 82) of patients; while 19% were sensible to all drugs. Phylogenetic analysis revealed that subtype B was predominant in the population (98%), excepting two cases of C and H subtypes respectively. Further analysis with env region revealed that one of these samples was a case of intergenic recombination Benv / Cpol. Pol analysis to determine Inter-subtype recombination showed three cases of B/C recombination and one complex case of K / F1 / CRF12.
Conclusions: This is the first report of HIV-1 subtypes C and H in Peru. Although these findings were obtained from a small population of HIV-infected patients, we presume that more cases might be circulating from treated-patients, or even more from high risk behavior population such as sex workers or men who have sex with men.
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