“Citomegalovírus: diversidade genética e pesquisa de resistência antiviral em pacientes imunodeficientes da cidade de Belém”

Abstract

Cytomegalovirus (CMV) is one of the most common cause of morbidity and mortality in immunocompromised patients because its latency and reactivation mechanism that commonly occurs in immunodeficiencies. Genetic analysis showed that the virulence of the strains may be related to genotypic diversity. The main objective of this paper was to describe the seroepidemiology profile and genetic diversity of CMV by detecting mutations that confer viral resistance to ganciclovir in immunodeficient patients from Belém city.A total of 671 samples were analyzed: 243 HIV/AIDS, 257 neoplastic patients, 112 kidney transplant and 60 people with SLE. The seroprevalence of antibodies was 96.1% and active infection and levels of 2.4% (n = 16) lower than that observed by qPCR method which corresponded to 15.63%. Differences in infection rates due to low sensitivity (5.71%) of the serological method demonstrated in screening test. The mutation research was made in 82 samples for pyrosequencing method, a 741pb segment of the UL97 gene was amplified, between 1087-1828 nucleotides. It was observed that 100% (n = 82) of samples had two mutations in amino acid in codon 596 (E596K) and another one in codon 604 (S604F). The S604F mutation was not found in other viral sequences from GenBank. Ten other mutations occurred between codons 377 and 594 in eight samples, including the A594V mutation in a renal transplant patient who ended up dying.It was concluded that the prevalence of antibodies and the epidemiological profile of the group were similar to those observed in populations of developing countries; the viral infection rates are related to viral reactivation, being underestimated by serology; sequence analysis revealed significant genetic diversity in the samples examined; detection of A594V mutation suggests circulating strains with resistance mutation.