title: Duplication of peri-kappaB and NF-kappab sites of the first human immunodeficiency virus type 2 (HIV-2) transmission in Brazil.
abstract: After the identification of HIV-2 in 1986, most of the cases reported have been concentrated in West Africa. We identified a case of HIV-2 infection in São Paulo, Brazil of a 45-year-old female who presented with Pneumocystis carinii pneumonia, with a CD4 count of 22 cells/ml. DNA samples from this patient were subjected to end-point PCR amplification of the LTR region. Clones were sequenced and subjected to phylogenetic analyses. All clones were subtype A related, and four presented an insertion, corresponding to an extra NF-kappaB site. This is the first confirmed case report of an HIV-2-infected subject identified in Brazil whose transmission occurred within the country. Furthermore, the NF-kappaB duplication would potentially be associated with an increase in viral cytopathogenicity. This raises concern for the need for permanent monitoring of the spread of HIV-2 in different areas of the world, even considering its lower rate of transmission and pathogenicity when compared to HIV-1.
authors.affiliation: Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Erika E
authors.initials: EE
authors.lastname: Fusuma
authors.forename: Sylvia C
authors.initials: SC
authors.lastname: Caruso
authors.forename: David Francisco
authors.initials: DF
authors.lastname: Lopez
authors.forename: Luciana Jesus
authors.initials: LJ
authors.lastname: Costa
authors.forename: Luiz Mário
authors.initials: LM
authors.lastname: Janini
authors.forename: João Silva
authors.initials: JS
authors.lastname: De Mendonça
authors.forename: Esper Georges
authors.initials: EG
authors.lastname: Kallas
authors.forename: Ricardo Sobhie
authors.initials: RS
authors.lastname: Diaz
mesh_terms: D001483:Base Sequence; D001938:Brazil; D018791:CD4 Lymphocyte Count; D005260:Female; D016322:HIV Enhancer / Q000235:genetics*; D015658:HIV Infections / Q000150:complications / Q000635:transmission* / Q000821:virology*; D016325:HIV Long Terminal Repeat / Q000235:genetics; D015498:HIV-2 / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D011020:Pneumonia, Pneumocystis / Q000150:complications; D017422:Sequence Analysis, DNA