Untitled

Funder

Organizational Unit

Publications

HIV-1 Diversity, Transmission Dynamics and Primary Drug Resistance in Angola

Publication . Bártolo, Inês; Zakovic, Susana; Martin, Francisco; Palladino, Claudia; Carvalho, Patrícia; Camacho, Ricardo; Thamm, Sven; Clemente, Sofia; Taveira, Nuno

"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."

2014-12-05Journal article

Open access

Evaluation of an in-house molecular HIV-1 test to assess mother-to-child HIV-1 transmission in Angola (the APEHC cohort)

Publication . Martin, F.; Palladino, C.; Mateus, R.; Clemente, S.; Gomes, P.; Taveira, N.

"Mother-to-child-transmission (MTCT) rate has decreased sharply in recent years in most of the sub-Saharan Africa, however 220,000 children acquired HIV-1 in 2014. PCR detection of proviral DNA is the most sensitive method for early infant diagnosis (EID) of HIV-1 infection. Commercial kits are available but they have poor sensitivity with divergent non-B subtypes and high costs (≈30€ per test) which limit their use in resource-limited settings. The HIV-1 epidemic in Angola is driven by highly divergent strains of all group M subtypes, except B, as well as multiple recombinant forms (CRFs and URFs) making EID a challenge in this setting. The aim of this study was to develop and validate a qualitative, inexpensive and sensitive “inhouse” HIV-1 EID assay on heel prick dried blood spots (DBS) from infants of the Hospital da Divina Providência (HDP) in Luanda, Angola and determine the current HIV-1 MTCT rate in the Angolan PErinatal HIV Cohort (APEHC)."

2015-09-27Conference object

Open access