RESUMEN
HIV-1 subtype B is the most frequent strain in Peru. However, there is no available data about the genetic diversity of HIV-infected patients receiving highly active antiretroviral therapy (HAART) here. A group of 267 patients in the Peruvian National Treatment Program with virologic failure were tested for genotypic evidence of HIV drug resistance at the Instituto Nacional de Salud (INS) of Peru between March 2008 and December 2010. Viral RNA was extracted from plasma and the segments of the protease (PR) and reverse transcriptase (RT) genes were amplified by reverse transcriptase polymerase chain reaction (RT-PCR), purified, and fully sequenced. Consensus sequences were submitted to the HIVdb Genotypic Resistance Interpretation Algorithm Database from Stanford University, and then aligned using Clustal X v.2.0 to generate a phylogenetic tree using the maximum likelihood method. Intrasubtype and intersubtype recombination analyses were performed using the SCUEAL program (Subtype Classification by Evolutionary ALgo-rithms). A total of 245 samples (91%) were successfully genotyped. The analysis obtained from the HIVdb program showed 81.5% resistance cases (n=198). The phylogenetic analysis revealed that subtype B was predominant in the population (98.8%), except for new cases of A, C, and H subtypes (n=4). Of these cases, only subtype C was imported. Likewise, recombination analysis revealed nine intersubtype and 20 intrasubtype recombinant cases. This is the first report of the presence of HIV-1 subtypes C and H in Peru. The introduction of new subtypes and circulating recombinants forms can make it difficult to distinguish resistance profiles in patients and consequently affect future treatment strategies against HIV in this country.
Asunto(s)
Terapia Antirretroviral Altamente Activa/métodos , Variación Genética , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , VIH-1/clasificación , Recombinación Genética , Adolescente , Adulto , Anciano , Farmacorresistencia Viral , Femenino , Genotipo , Proteasa del VIH/genética , Transcriptasa Inversa del VIH/genética , VIH-1/efectos de los fármacos , VIH-1/genética , VIH-1/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Perú , Plasma/virología , ARN Viral/genética , ARN Viral/aislamiento & purificación , Análisis de Secuencia de ADN , Adulto JovenRESUMEN
Objetivo. Determinar la prevalencia de enfermedades transmisibles, salud mental y exposición a contaminantes ambientales en la población aledaña al proyecto minero Las Bambas antes de la fase de explotación. Materiales y métodos. Estudio descriptivo transversal realizado en 453 personas (niños y adultos) residentes en tres distritos de la región Apurímac: Haquira, Chalhuahuacho y Progreso. Se evaluó el desarrollo psicomotor, coeficiente intelectual y niveles de ansiedad y depresión, así como la presencia de enfermedades transmisibles (sífilis, VIH, hepatitis viral B, C y Delta,) metales pesados (nivel de plomo en sangre, nivel de cadmio, arsénico y mercurio, en orina) y colinesterasa sérica. Resultados. La edad promedio fue de 29,0 ± 17,3 años, 59,2 por ciento fueron mujeres y el tiempo de residencia fue de 6 a 15 años. No se encontraron casos de VIH, hepatitis C y Delta, 1,4 por ciento fueron positivos a sífilis y en relación con hepatitis B se encontró 1,7 por ciento positivos a anti HBc total y 0,5 por ciento positivos a HBs Ag. Se encontraron valores por encima de lo permitido de mercurio en 1,8 por ciento de la población, arsénico en 4,6 por ciento, plomo en 24,3 por ciento y cadmio en 43,9 por ciento. Además, el 29,1 por ciento de la población tuvo valores de colinesterasa inferiores al rango referencial. En la población infantil, 12,5 por ciento presentaba riesgo en su desarrollo psicomotor; 2,1 por ciento y 3,1 por ciento presentaba retardo mental leve y fronterizo, respectivamente; 34,3 por ciento de los mayores de 12 años sufrían de ansiedad y 17,5 por ciento de depresión. Conclusiones. Existen evidencias de contaminación ambiental por metales pesados y presencia de enfermedades transmisibles en esta población. Una futura explotación minera irresponsable podría agravar dicha situación epidemiológica.
Objective. To determine the prevalence of communicable diseases, mental health and environmental pollutants exposure in population living near Las Bambas mining project before exploitation phase. Material and methods. Cross sectional study performed in 453 subjects (children and adults) living in three Apurimac region districts: Haquira, Chalhuahuacho and Progreso. Psychomotor development, intelligence quotient, anxiety and depression levels and the presence of communicable diseases (viral hepatitis B, C and delta, syphilis and HIV) were evaluated, as well as heavy metals (lead in blood, and cadmium, arsenic and mercury in urine samples) and serum cholinesterase levels. Results. Mean age was 29 ± 17.25 years, 59.2 percent were female and a range of 6 to 15 years of living in the area was found. No cases of HIV, hepatitis C and delta were found, 1.4 percent were positive for syphilis and in relation to hepatitis B, we found 1,7 percent of subjects positive to total anti HBc and 0.5 percent positive for HBsAg. Heavy metal testing identified people with exceeding limits of mercury in 1.8 percent arsenic in 4.6 percent, lead in 24.3 percent and cadmium in 43.9 percent. Besides, 29.1 percent of the population had cholinesterase levels below normal range. Among children, 12.5 percent were at psychomotor development levels of risk; 2.1 percent and 3.1 percent suffered from mild and borderline intellectual disability (mental retardation), respectively. 34.3 percent of subjects older than 12 had anxiety and 17.5 percent depression. Conclusions. Evidence of heavy metal environmental pollution and presence of communicable diseases in this population were already found. Future careless mining activity could worsen the current health situation.
Asunto(s)
Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto Joven , Enfermedades Transmisibles/epidemiología , Exposición a Riesgos Ambientales/efectos adversos , Contaminantes Ambientales/efectos adversos , Trastornos Mentales/epidemiología , Minería , Estudios Transversales , Trastornos Mentales/etiología , Salud Mental , Perú/epidemiologíaRESUMEN
OBJECTIVE: To determine the prevalence of communicable diseases, mental health and environmental pollutants exposure in population living near Las Bambas mining project before exploitation phase. MATERIAL AND METHODS: Cross sectional study performed in 453 subjects (children and adults) living in three Apurimac region districts: Haquira, Chalhuahuacho and Progreso. Psychomotor development, intelligence quotient, anxiety and depression levels and the presence of communicable diseases (viral hepatitis B, C and delta, syphilis and HIV) were evaluated, as well as heavy metals (lead in blood, and cadmium, arsenic and mercury in urine samples) and serum cholinesterase levels. RESULTS: Mean age was 29 ± 17.25 years, 59.2% were female and a range of 6 to 15 years of living in the area was found. No cases of HIV, hepatitis C and delta were found, 1.4% were positive for syphilis and in relation to hepatitis B, we found 1,7% of subjects positive to total anti HBc and 0.5% positive for HBsAg. Heavy metal testing identified people with exceeding limits of mercury in 1.8% arsenic in 4.6%, lead in 24.3% and cadmium in 43.9%. Besides, 29.1% of the population had cholinesterase levels below normal range. Among children, 12.5% were at psychomotor development levels of risk; 2.1% and 3.1% suffered from mild and borderline intellectual disability (mental retardation), respectively. 34.3% of subjects older than 12 had anxiety and 17.5% depression. CONCLUSIONS: Evidence of heavy metal environmental pollution and presence of communicable diseases in this population were already found. Future careless mining activity could worsen the current health situation.
Asunto(s)
Enfermedades Transmisibles/epidemiología , Exposición a Riesgos Ambientales/efectos adversos , Contaminantes Ambientales/efectos adversos , Trastornos Mentales/epidemiología , Minería , Adolescente , Adulto , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Trastornos Mentales/etiología , Salud Mental , Persona de Mediana Edad , Perú/epidemiología , Adulto JovenRESUMEN
We investigated the prevalence and molecular epidemiology of human T cell lymphotropic virus type 1 in Peruvian HIV-1-positive subjects, and found a 10.1% prevalence in a consecutive series of 318 HIV-1-positive patients living in Lima. Phylogenetic analysis of the long terminal repeat of 10 patient isolates showed that all of them belonged to the HTLV-1aA (Transcontinental) subgroup. Although the majority of the Peruvian sequences included in the analysis formed a clade with other Latin American sequences, the isolates of three patients clustered significantly with South African strains. These data show a high prevalence of HTLV-1 infection in HIV-1-positive subjects living in Lima and confirm the presence in Latin America of HTLV-1 strains probably arising from South Africa.
Asunto(s)
Evolución Molecular , Infecciones por HTLV-I/epidemiología , Virus Linfotrópico T Tipo 1 Humano/genética , Filogenia , Adulto , Femenino , Infecciones por HTLV-I/virología , Virus Linfotrópico T Tipo 1 Humano/clasificación , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Humanos , Masculino , Datos de Secuencia Molecular , Perú/epidemiología , Prevalencia , Análisis de Secuencia de ADN , SudáfricaRESUMEN
Desde 1990 en el INS Perú se viene utilizando la técnica de Western Blot (WB) para la confirmación del Diagnóstico de VIH. En este estudio se evalua la prueba de inmunofluorescencia indirecta (IFI) como una alternativa de confirmación al Western Blot. Se utilizaron 132 sueros de la seroteca de la División de Virología del INS Perú con diagnóstico previo de VIH por WB. Para el diagnóstico de IFI se usó un kit producido en el Centro Nacional de Referencia de SIDA (Chile-Argentina). De los 132 sueros procesados 56 (42,4) correspondieron a Western Blot positivo, 52 (39,4) a Western Blot negativos y 24 (18,2) con Western Blot indeterminado. La sensibilidad y especificidad de la técnica IFI en comparación con la de Western Blot fue de 98,2 y 98 respectivamente. Los valores predictivo positivo y negativo fueron 98,2 y 100, respectivamente. Estos resultados permiten incorporar a la técnica de IFI como una prueba alternativa para la confirmación de diagnóstico de infección por VIH