title: Variability in HIV-1 partial genomic sequences in Costa Rican patients: analysis with different bioinformatics tools.
abstract: OBJECTIVE
  To estimate subtype and genomic variability in the HIV pol gene of Costa Rican patients by using different bioinformatics tools and to use this information to establish new policies to better manage these patients.
  
  
  METHODS
  A total of 113 pol sequences available from Costa Rican patients under highly active antiretroviral therapy were analyzed by using the Genotyping, REGA, Stanford, and MEGA programs. The pol sequences came from 77 virologic failures (VF) and 36 basal samples (BS). Of the 77 VF, 22 also were sequenced in the env region.
  
  
  RESULTS
  No major differences were found among the variables studied. However, there was a tendency for more variability in VF patients with a high baseline viral load. In the pol gene, 75%-83% of BS and 66%-75% of VF samples were pure B subtype by Genotyping and REGA, respectively. The other samples presented variations related mainly to circulating recombinant form CRF12 by genotyping or to CRF17 or -29 by phylogenetic analysis or a new possible BD recombinant with all programs. In the Stanford program, all variable samples showed a subtype B with high polymorphism. The variability in the env sequences was lower than that in the pol region.
  
  
  CONCLUSIONS
  The B subtype is predominant in Costa Rican HIV-positive patients. There is high variability within sequences with potential recombination between B and F or D subtypes. The BD recombinant has not been previously reported. This high variability is likely the result of possible recombinant events, nonadherence to antiretroviral therapy, sexual intercourse without protection, and many sexual partners. Similar studies should be done in other countries in the Region, in particular in those places with extensive immigration, in order to decrease the possibility of virus variability as well as the cost of antiretroviral therapy.
authors.affiliation: Centro de Investigación en Enfermedades Tropicales, Microbiology Faculty, University of Costa Rica, San Pedro Montes de Oca, Costa Rica. MAYRA.TAYLOR@ucr.co.cr
authors.forename: Lizeth
authors.initials: L
authors.lastname: Taylor-Castillo
authors.forename: María Paz
authors.initials: MP
authors.lastname: León-Bratti
authors.forename: Antonio
authors.initials: A
authors.lastname: Solano-Chinchilla
authors.forename: Gisela
authors.initials: G
authors.lastname: Herrera-Martínez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Boza-Cordero
authors.forename: Bernal
authors.initials: B
authors.lastname: León
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Luftig
authors.forename: Kirsten
authors.initials: K
authors.lastname: Visoná
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D019295:Computational Biology / Q000379:methods*; D003364:Costa Rica; D005260:Female; D015752:Genes, env; D015751:Genes, pol; D014644:Genetic Variation; D016679:Genome, Viral; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010802:Phylogeny; D011995:Recombination, Genetic; D016415:Sequence Alignment; D017423:Sequence Analysis, RNA; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012984:Software; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents