Caracterização molecular da epimedia do HIV-1 em cidades do interior de Santa Catarina e Rio Grande do Sul e filogeografia do subtipo C no Brasil

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências Biológicas, Programa de Pós-Graduação em Biotecnologia e Biociências, Florianópolis, 2015.A epidemia de HIV/aids na região Sul do Brasil é distinta da observada em outras regiões do país. Principalmente nos estados de Santa Catarina (SC) e do Rio Grande do Sul (RS) as taxas de incidência anual de aids e de mortalidade pela doença são bem maiores que a média nacional. Além disso, na mesma região é encontrada grande prevalência de subtipo C enquanto nos outros estados brasileiros há predominância do subtipo B. Uma minuciosa revisão da bibliografia revelou que, apesar de vários estudos já terem descrito a epidemia molecular do subtipo C nas capitais do Sul do Brasil, uma investigação que abrangesse de forma representativa a população dessa região ainda fazia-se necessária. Em vista disso, o trabalho apresentado aqui estudou a epidemia do HIV em 13 municípios do interior dos estados de SC e do RS. Material biológico e dados epidemiológicos de aproximadamente 350 pacientes foram coletados e utilizados para montar um banco de dados com informações moleculares, clínicas e demográficas. Em praticamente todas as cidades amostradas, mas principalmente em SC, o HIV-1 subtipo C mostrou-se como forma predominante. No RS, um número maior de formas recombinantes foi observado com três possíveis novas formas circulantes recombinantes (CRF) identificadas. Análises filodinâmicas revelaram um crescimento mais rápido da epidemia do HIV-1 subtipo C em relação ao subtipo B, sendo esta diferença ainda mais pronunciada em SC, onde também observou-se uma clara segregação dos subtipos virais entre categorias de exposição. Os dados coletados aqui ainda foram utilizados em um estudo filogeográfico para descrever a expansão da epidemia do subtipo C pelo Brasil. Através da análise integrada de dados ecológicos e moleculares foi identificado que a origem dessa epidemia ocorreu em Porto Alegre e a partir desta cidade o subtipo C foi sendo progressivamente introduzido em cidades mais distantes e/ou isoladas. A prevalência de HIV-1 e o número de pessoas infectadas pelo subtipo C foram identificados como preditores da dispersão viral do Sul ao Norte do país. Em conclusão, os resultados apresentados aqui revelam o rápido crescimento que a epidemia do HIV-1 subtipo C teve em SC e RS; discute como a separação em diferentes grupos de exposição pode impactar na velocidade de expansão e também na formação de novas recombinantes; e ainda descreve as rotas de dispersão do subtipo C rumo ao norte do Brasil, alertando para o potencial expansivo dessa epidemia em outras regiões, principalmente no Centro-Oeste.Abstract : The HIV/AIDS epidemic in Brazilian Southern region is distinct than that observed in other parts of the country. Mainly in the states of Santa Catarina (SC) and Rio Grande do Sul (RS) the annual aids incidence and mortality rates are far higher than the national average. Furthermore, in the same states HIV-1 epidemic is driven by subtype C, while in other Brazilian regions subtype B is more prevalent. A detailed review of the bibliography revealed that studies describing the molecular epidemiology in south Brazil were mainly performed in the capital cities and that a more comprehensive characterization of the epidemic was necessary. In view of this, the study presented here investigated the HIV epidemic in 13 countryside municipalities form SC and RS states. Blood samples and epidemiological data were collected and assembled in a databank with molecular, clinical and demographic information from around 350 HIV sero-positive individuals. HIV-1 subtype C was observed to be the most prevalent in virtually all sampled locations, with higher frequencies in SC. HIV recombinant forms were observed in higher frequencies in RS, where some possible new CRFs were also identified. Phylodynamic analyses revealed a faster epidemic growth rate for subtype C in comparison with subtype B. This difference was more pronounced in SC where was also observed subtype segregation in categories of exposure. In addition, data collected here was also used in a phylogeographical investigation of the subtype C dispersion throughout Brazil. By using a new approach which integrates ecological and molecular data in the phylogeographical reconstructions, Porto Alegre was found to be the origin of subtype C epidemic and the central hub of dispersion towards north Brazil. HIV prevalence and subtype C population size were identified as predictors of the viral diffusion. In conclusion, the results presented here reveal the fast epidemic growth that subtype C went through in RS and SC; discuss how viral segregation in separated exposure categories can impact in the epidemic growth rates and in the emergence of recombinant forms; and, finally, describe the northward dispersion of subtype C, highlighting the potential to increase in prevalence mainly in Central-West region

Transmission networks and risk of HIV infection in KwaZulu-Natal, South Africa : a community-wide phylogenetic study.

CAPRISA, 2017.Abstract available in pdf

Moderate-to-high levels of pretreatment HIV drug resistance in KwaZulu-Natal Province, South Africa.

CAPRISA, 2019.Abstract available in PDF

New Insights on the Zika Virus Arrival in the Americas and Spatiotemporal Reconstruction of the Epidemic Dynamics in Brazil.

Zika virus (ZIKV) became a worldwide public health emergency after its introduction in the Americas. Brazil was implicated as central in the ZIKV dispersion, however, a better understanding of the pathways the virus took to arrive in Brazil and the dispersion within the country is needed. An updated genome dataset was assembled with publicly available data. Bayesian phylogeography methods were applied to reconstruct the spatiotemporal history of ZIKV in the Americas and with more detail inside Brazil. Our analyses reconstructed the Brazilian state of Pernambuco as the likely point of introduction of ZIKV in Brazil, possibly during the 2013 Confederations Cup. Pernambuco played an important role in spreading the virus to other Brazilian states. Our results also underscore the long cryptic circulation of ZIKV in all analyzed locations in Brazil. Conclusions: This study brings new insights about the early moments of ZIKV in the Americas, especially regarding the Brazil-Haiti cluster at the base of the American clade and describing for the first time migration patterns within Brazil

Phylogeographic Analysis of HIV-1 Subtype C Dissemination in Southern Brazil

The HIV-1 subtype C has spread efficiently in the southern states of Brazil (Rio Grande do Sul, Santa Catarina and Paraná). Phylogeographic studies indicate that the subtype C epidemic in southern Brazil was initiated by the introduction of a single founder virus population at some time point between 1960 and 1980, but little is known about the spatial dynamics of viral spread. A total of 135 Brazilian HIV-1 subtype C pol sequences collected from 1992 to 2009 at the three southern state capitals (Porto Alegre, Florianópolis and Curitiba) were analyzed. Maximum-likelihood and Bayesian methods were used to explore the degree of phylogenetic mixing of subtype C sequences from different cities and to reconstruct the geographical pattern of viral spread in this country region. Phylogeographic analyses supported the monophyletic origin of the HIV-1 subtype C clade circulating in southern Brazil and placed the root of that clade in Curitiba (Paraná state). This analysis further suggested that Florianópolis (Santa Catarina state) is an important staging post in the subtype C dissemination displaying high viral migration rates from and to the other cities, while viral flux between Curitiba and Porto Alegre (Rio Grande do Sul state) is very low. We found a positive correlation (r2 = 0.64) between routine travel and viral migration rates among localities. Despite the intense viral movement, phylogenetic intermixing of subtype C sequences from different Brazilian cities is lower than expected by chance. Notably, a high proportion (67%) of subtype C sequences from Porto Alegre branched within a single local monophyletic sub-cluster. These results suggest that the HIV-1 subtype C epidemic in southern Brazil has been shaped by both frequent viral migration among states and in situ dissemination of local clades

Ocorrência do gene bla de metalo-β-lactamases em Pseudomonas aeruginosa oriundos de amostras clínicas do interior do Rio Grande do Sul

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