Barreto Claudia C, Nishyia Anna, Araújo Luciano V, Ferreira João E, Busch Michael P, Sabino Ester C
Fundaçaõ Pró-Sangue/Hemocentro de Saõ Paulo, Av. Dr. Enéas de Carvalho Aguilar, 15505403-000 Saõ Paulo, Brazil.
J Acquir Immune Defic Syndr. 2006 Mar;41(3):338-41. doi: 10.1097/01.qai.0000199097.88344.50.
We analyzed rates of drug resistance mutations in antiretroviral-naive São Paulo blood donors with recently acquired or established HIV-1 infections and characterized clade diversity in this population.
Six hundred forty-eight seropositive blood donor specimens were identified at the Blood Center of São Paulo between July 1998 and March 2002. To discriminate recent infections, samples were subjected to the standardized testing algorithm for recent HIV seroconversion (less-sensitive enzyme immunoassay) testing algorithm. There were 531 samples with a sufficient volume of serum to attempt polymerase chain reaction (PCR) and viral sequencing; 341 (64%) samples yielded a PCR product that could be sequenced for the reverse transcriptase and protease genes. Mutations were analyzed using the 2005 International AIDS Society mutation list.
Of 341 specimens successfully analyzed, 21 (6.3%; 95% confidence interval [CI]: 3.9% to 9.3%) had drug-resistant mutations. The proportion of resistant strains was 12.7% (95% CI: 5.2% to 24.5%) among recently infected individuals compared with 5.0% (95% CI: 2.8% to 8.2%) among those with long-standing infections (P = 0.03). No change in the proportion of drug-resistant strains was observed among recently infected donor samples from the first half of the study period (4 of 32 samples) as compared with the second half (3 of 23 samples; P = 0.95). Of the 341 samples, 277 (81.2%) were classified as subtype B, 25 (7.3%) as subtype F1, 13 (3.8%) as subtype C, and 26 (7.6%) as recombinant strains. The distribution of HIV-1 subtypes was similar among recent and long-standing infected individuals and over time.
The prevalence of drug-resistant mutations among newly diagnosed persons in São Paulo city is low and similar to what has been described in Europe and the United States. Although HIV-1 subtype B remains predominant, subtypes F and C and recombinant forms are present in substantial proportions in infected donors.
我们分析了近期感染或已确诊感染HIV-1的圣保罗初治抗逆转录病毒治疗献血者的耐药突变率，并对该人群的进化枝多样性进行了特征分析。
1998年7月至2002年3月期间，圣保罗血液中心共鉴定出648份血清学阳性献血者样本。为鉴别近期感染，样本接受了用于近期HIV血清转化的标准化检测算法（低敏感性酶免疫测定）检测算法。有531份样本血清量充足，可尝试进行聚合酶链反应（PCR）和病毒测序；341份（64%）样本产生了可对逆转录酶和蛋白酶基因进行测序的PCR产物。使用2005年国际艾滋病学会突变列表分析突变情况。
在成功分析的341份样本中，21份（6.3%；95%置信区间[CI]：3.9%至9.3%）存在耐药突变。近期感染个体中耐药菌株的比例为12.7%（95%CI：5.2%至24.5%），而长期感染个体中为5.0%（95%CI：2.8%至8.2%）（P = 0.03）。在研究期上半年的近期感染献血者样本中（32份样本中的4份），与下半年（23份样本中的3份；P = 0.95）相比，未观察到耐药菌株比例的变化。在341份样本中，277份（81.2%）被归类为B亚型，25份（7.3%）为F1亚型，13份（3.8%）为C亚型，26份（7.6%）为重组菌株。HIV-1亚型的分布在近期和长期感染个体中以及随时间推移相似。
圣保罗市新诊断人群中耐药突变的患病率较低，与欧洲和美国所描述的情况相似。尽管HIV-1 B亚型仍然占主导地位，但F亚型、C亚型和重组形式在感染的献血者中占相当大的比例。
