Viral metagenomics in individuals with HIV/AIDS late diagnosis

Abstract

Despite advances in prevention and testing programs a large proportion of individuals seeking first care to HIV / AIDS, whether in Anonymous Testing Centers (CTAs) and in hospitals, already have advanced HIV infection. Late diagnosis is closely related to ethnicity, gender, immigration and low educational socioeconomic status. In Brazil, besides these factors we have reported on studies that there is a lack of access or few CTAs making it difficult to testing for people living in rural and/or remote from the centers cities. We know that a person to become infected with HIV and can be infected with viral populations already resistant to the drugs used in the treatment and that many mutations in the genome of the virus that cause this resistance last for years (Transmitted Drug Resistance Mutations, TDRM). So it is important to study the presence of these TDRM as they represent an impediment in responding to antiretroviral treatment, especially in this group to be diagnosed as HIV + already has a high degree immunocompromised. An important aspect of immunocompromised is the increased diversity of viral communities (viroma) plasma and enteric observed in recent studies of metagenomics. With the new sequencing technologies, it is possible to identify and characterize the entire viral microorganisms of a specific population, as well as the functions of the viral gene and its association with different diseases. In fact, several studies using this technology for virus RNA and DNA sequences from different compartments (blood, nasal lavage, feces) than those already known, also found new viruses. Thus, the goal of this study is to perform viral metagenomic plasma and stool of individuals with HIV late diagnosed and characterize all viruses including new viruses; characterized transmitted drug resistance mutations in the viral populations of HIV-1; assess the impact of HIV late diagnosis and the socioeconomic profile featuring these patients. (AU)