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. 2013 Aug 7;8(8):e71999.
doi: 10.1371/journal.pone.0071999. Print 2013.

Mycobacterium tuberculosis Beijing genotype is associated with HIV infection in Mozambique

Sofia O Viegas  1 , Adelina Machado, Ramona Groenheit, Solomon Ghebremichael, Alexandra Pennhag, Paula S Gudo, Zaina Cuna, Egídio Langa, Paolo Miotto, Daniela M Cirillo, Nalin Rastogi, Rob M Warren, Paul D van Helden, Tuija Koivula, Gunilla Källenius
Affiliations

Mycobacterium tuberculosis Beijing genotype is associated with HIV infection in Mozambique

Sofia O Viegas et al. PLoS One. .

Abstract

The Beijing genotype is a lineage of Mycobacterium tuberculosis that is distributed worldwide and responsible for large epidemics, associated with multidrug-resistance. However, its distribution in Africa is less understood due to the lack of data. Our aim was to investigate the prevalence and possible transmission of Beijing strains in Mozambique by a multivariate analysis of genotypic, geographic and demographic data. A total of 543 M. tuberculosis isolates from Mozambique were spoligotyped. Of these, 33 were of the Beijing lineage. The genetic relationship between the Beijing isolates were studied by identification of genomic deletions within some Regions of Difference (RD), Restriction Fragment Length Polymorphism (RFLP) and Mycobacterial Interspersed Repetivie Unit - variable number tandem repeat (MIRU-VNTR). Beijing strains from South Africa, representing different sublineages were included as reference strains. The association between Beijing genotype, Human Immunodeficiency Virus (HIV) serology and baseline demographic data was investigated. HIV positive serostatus was significantly (p=0.023) more common in patients with Beijing strains than in patients with non-Beijing strains in a multivariable analysis adjusted for age, sex and province (14 (10.9%) of the 129 HIV positive patients had Beijing strains while 6/141 (4.3%) of HIV negative patients had Beijing strains). The majority of Beijing strains were found in the Southern region of Mozambique, particularly in Maputo City (17%). Only one Beijing strain was drug resistant (multi-drug resistant). By combined use of RD and spoligotyping, three genetic sublineages could be tentatively identified where a distinct group of four isolates had deletion of RD150, a signature of the "sublineage 7" recently emerging in South Africa. The same group was very similar to South African "sublineage 7" by RFLP and MIRU-VNTR, suggesting that this sublineage could have been recently introduced in Mozambique from South Africa, in association with HIV infection.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Distribution of Beijing genotype in Mozambique.
Map of Mozambique showing the distribution of Beijing genotype in the country, prevalence among the total number of isolates per province. In the provinces of Sofala, Manica, Tete and Niassa non Beijing strain was found.
Figure 2
Figure 2. IS6110 RFLP dendrogram of Beijing genotype strains from Mozambique and South Africa.
The dendogram includes 36 M. tuberculosis Beijing genotype strains, 23 from Mozambique and 13 from South Africa. Red rectangle indicates sublineage 7 and sublineage C isolates from South Africa and Mozambique respectively; Highlighted area shows the clustered isolates from both sublineages. a Drug resistant isolate b SIT 190 isolate
Figure 3
Figure 3. 24 loci MIRU-VNTR dendrogram of Beijing genotype strains from Mozambique and South Africa.
The dendrogram includes 87 M. tuberculosis Beijing genotype strains, 30 from Mozambique and 57 from South Africa. Red rectangle indicates sublineage 7 and sublineage C isolates from South Africa and Mozambique respectively. a Drug resistant isolate b SIT 190 isolate
See this image and copyright information in PMC

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