Human immunodeficiency virus infection and syphilis among homeless people in a large city of central-western Brazil: prevalence, risk factors, human immunodeficiency virus-1 genetic diversity, and drug resistance mutations
Nenhuma Miniatura disponível
Data
2021
Autores
Título da Revista
ISSN da Revista
Título de Volume
Editor
Resumo
Homeless people are at high risk for sexually transmitted infections (STIs), such as human
immunodeficiency virus (HIV) infection and syphilis. We investigated the epidemiology of
HIV-1 infection and syphilis among homeless individuals in a large city in Central-Western
Brazil. In this cross-sectional study, we interviewed and tested 355 individuals from Septem ber 2014 to August 2015. Rapid test samples positive for syphilis were retested using the
Venereal Disease Research Laboratory (VDRL) test. Blood samples from HIV-infected partic ipants were collected for POL sequencing using HIV-1 RNA extracted from plasma, reverse
transcription, and nested polymerase chain reaction. Anti-HIV-1-positive samples were
subtyped by sequencing the nucleotides of HIV-1 protease and part of the HIV-1 reverse
transcriptase genes. Transmitted and acquired drug resistance mutations and susceptibil ity to antiretroviral drugs were also analyzed. Anti-HIV was positive in 14 patients (3.9%;
95% confidence interval [CI]: 2.3–6.4). HIV-1 RNA was detected in 8 of the 14 samples. Two
of the eight (25%) isolates showed HIV-1 drug resistance mutations. Furthermore, 78 (22%;
95% CI: 17.9–26.5) and 29 (8.2%; 95% CI: 5.6–11.4) homeless individuals tested positive for syphilis using the rapid test and VDRL test, respectively. Two individuals were anti-HIV-1
and VDRL test positive. Daily alcohol use (adjusted odds ratio [AOR]: 3.2, 95% CI: 1.0–10.4),
sex with people living with HIV (PLWH) infection (AOR: 6.8, 95% CI: 1.9–25.0), and sex with
people of the same sex (AOR: 5.4, 95% CI: 1.7–17.5) were predictors of HIV infection. Age ≤35
years (AOR: 3.8, 95% CI: 1.4–10.8), previous syphilis testing (AOR: 3.5, 95% CI: 1.4–8.4), history
of genital lesions (AOR: 4.9, 95% CI: 1.3–19.1), and crack use in the last six months (AOR:
3.1, 95% CI: 1.3–7.6) were predictors of syphilis. Our findings highlight the importance of STI
prevention and control strategies among the homeless.
Descrição
Palavras-chave
Human immunodeficiency virus, Syphilis, Homeless, Risk factors, Drug resistance, Brazil
Citação
PINHEIRO, Raquel Silva et al. Human immunodeficiency virus infection and syphilis among homeless people in a large city of central-western Brazil: prevalence, risk factors, human immunodeficiency virus-1 genetic diversity, and drug resistance mutations. Brazilian Journal of Infectious Diseases, Salvador, v. 25, n. 1, e101036, 2021. DOI: 10.1016/j.bjid.2020.11.001. Disponível em: https://www.sciencedirect.com/science/article/pii/S1413867020301586?via%3Dihub. Acesso em: 11 fev. 2025.