Genetic diversity and HIV-1 incidence estimation among cocaine users in São Paulo, Brazil.
We describe HIV-1 incidence and the prevalence of genetic subtypes among cocaine users in São Paulo, Brazil. A cross-sectional HIV-1 survey was carried out among 839 current cocaine users attending seven drug treatment units in the São Paulo metropolitan area from 1997 to 1998. HIV-1 subtyping was performed among 41 positive individuals using the heteroduplex mobility assay and DNA sequencing. Participants were mainly male (95.7%) with a history of previous imprisonment (54%), and the mean age was 26.9 years (SD = 7.2). The majority (64.4%) were current crack cocaine users, and 82.1% of the total participants were noninjectors. HIV-1 seroprevalence was 4.9% (95% confidence interval [CI], 3.6%-6.6%), and the incidence (estimated by the sensitive/less-sensitive immunoassay testing strategy) was 0.71% per year (95% CI, 0.07-3.03). HIV-1 subtype B was predominant (90.3%), followed by subtype F. There was no statistically significant association between HIV-1 subtype and specific route of drug administration. Our incidence data show evidence of recent HIV-1 transmission among cocaine users, mainly among noninjectors. Detection of recently infected HIV-1 cases linked to genetic diversity analysis may provide baseline information for public health interventions in this sentinel group.
Turchi
Marília Dalva
MD
Instituto de Patologia Tropical e Saúde Pública, Federal University of Goiás, Goiás, Brazil. mturchi@cultura.com.br
Diaz
Ricardo Sobhie
RS
Martelli
Celina Maria Turchi
CM
Sabino
Ester Cerdeiro
EC
Da Silva
Wilson Pereira
WP
Filho
Olavo Ferreira
OF
Laranjeira
Ronaldo Ramos
RR
Busch
Michael P
MP
Castelo
Adauto
A
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000150:complications*; D016578:Crack Cocaine; D005260:Female; D014644:Genetic Variation; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000145:classification* / Q000235:genetics; D006801:Humans; D015994:Incidence; D008297:Male; D008969:Molecular Sequence Data; D010802:Phylogeny; D015995:Prevalence; D017422:Sequence Analysis, DNA
D016578:Crack Cocaine