HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression
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| Format: | Artículo científico |
| Langue: | en |
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Medical Education Cooperation with Cuba
2015
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| author | Madeline Blanco |
| author_facet | Madeline Blanco |
| contents | HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression Madeline Blanco Liuber Y. Machado Héctor Díaz Nancy Ruiz Dania Romay Eladio Silva Medicina HIV AIDS Cuba clini subtypes INTRODUCTION Serological and molecular HIV-1 studies in Cuba have shown very low prevalence of seropositivity, but an increasing genetic diversity attributable to introduction of many HIV-1 variants from different areas, exchange of such variants among HIV-positive people with sever- al coinciding routes of infection and other epidemio logic risk factors in the seropositive population. The high HIV-1 genetic variability observed in Cuba has possible implications for transmission and clinical progression. OBJECTIVE Study genetic variability for the HIV-1 env , gag and pol structural genes in Cuba; determine the prevalence of B and non-B subtypes according to epidemiologic and behavioral variables and determine whether a relationship exists between genetic variability and transmissibility, and between genetic variability and clinical dis ease pro- gression in people living with HIV/AIDS. METHODS Using two molecular assays (heteroduplex mobility assay and nucleic acid sequencing), structural genes were characterized in 590 people with HIV-1 (480 men and 110 women), accounting for 3.4% of seropositive individuals in Cuba as of December 31, 2013. Nonrandom sampling, proportional to HIV prevalence by province, was conducted. Relationships between molecular results and viral factors, host charac- teristics, and patients’ clinical, epidemiologic and behavioral variables were studied for molecular epidemiology, trans mission, and progression analyses. RESULTS Molecular analysis of the three HIV-1 structural genes clas sified 297 samples as subtype B (50.3%), 269 as non-B subtypes (45.6%) and 24 were not typeable. Subtype B prevailed overall and in men, mainly in those who have sex with men. Non-B subtypes were prevalent in women and heterosexual men, showing multiple circulating variants and recombi- nant forms. Sexual transmission was the predominant form of infection for all. B and non-B subtypes were encountered throughout Cuba. No asso- ciation was found between subtypes and transmission or clinical progres- sion, although the pro portion of deaths was higher for subtype B. Among those who died during the study period, there were no differences between subtypes in the mean time from HIV or AIDS diagnosis to death. CONCLUSIONS Our results suggest that B and non-B HIV-1 sub types found in Cuba do not differ in transmissibility and in clinical dis ease pro- gression. 2015 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437543389006 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.4 Vol.17 |
| format | Artículo científico |
| id | redalyc_437543389006 |
| institution | Redalyc |
| language | en |
| publishDate | 2015 |
| publisher | Medical Education Cooperation with Cuba |
| spellingShingle | HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression Madeline Blanco Medicina HIV AIDS Cuba clini subtypes HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression Madeline Blanco Liuber Y. Machado Héctor Díaz Nancy Ruiz Dania Romay Eladio Silva Medicina HIV AIDS Cuba clini subtypes INTRODUCTION Serological and molecular HIV-1 studies in Cuba have shown very low prevalence of seropositivity, but an increasing genetic diversity attributable to introduction of many HIV-1 variants from different areas, exchange of such variants among HIV-positive people with sever- al coinciding routes of infection and other epidemio logic risk factors in the seropositive population. The high HIV-1 genetic variability observed in Cuba has possible implications for transmission and clinical progression. OBJECTIVE Study genetic variability for the HIV-1 env , gag and pol structural genes in Cuba; determine the prevalence of B and non-B subtypes according to epidemiologic and behavioral variables and determine whether a relationship exists between genetic variability and transmissibility, and between genetic variability and clinical dis ease pro- gression in people living with HIV/AIDS. METHODS Using two molecular assays (heteroduplex mobility assay and nucleic acid sequencing), structural genes were characterized in 590 people with HIV-1 (480 men and 110 women), accounting for 3.4% of seropositive individuals in Cuba as of December 31, 2013. Nonrandom sampling, proportional to HIV prevalence by province, was conducted. Relationships between molecular results and viral factors, host charac- teristics, and patients’ clinical, epidemiologic and behavioral variables were studied for molecular epidemiology, trans mission, and progression analyses. RESULTS Molecular analysis of the three HIV-1 structural genes clas sified 297 samples as subtype B (50.3%), 269 as non-B subtypes (45.6%) and 24 were not typeable. Subtype B prevailed overall and in men, mainly in those who have sex with men. Non-B subtypes were prevalent in women and heterosexual men, showing multiple circulating variants and recombi- nant forms. Sexual transmission was the predominant form of infection for all. B and non-B subtypes were encountered throughout Cuba. No asso- ciation was found between subtypes and transmission or clinical progres- sion, although the pro portion of deaths was higher for subtype B. Among those who died during the study period, there were no differences between subtypes in the mean time from HIV or AIDS diagnosis to death. CONCLUSIONS Our results suggest that B and non-B HIV-1 sub types found in Cuba do not differ in transmissibility and in clinical dis ease pro- gression. 2015 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437543389006 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.4 Vol.17 |
| title | HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression |
| topic | Medicina HIV AIDS Cuba clini subtypes |
| url | https://www.redalyc.org/articulo.oa?id=437543389006 |