Abstract
BackgroundThe HIV epidemic is increasing in Equatorial Guinea (GQ), West Central Africa, but few studies have reported its HIV molecular epidemiology. We aimed to describe the HIV-1 group M (HIV-1M) variants and drug-resistance mutations in GQ using sequences sampled in this country and in Spain, a frequent destination of Equatoguinean migrants.MethodsWe collected 195 HIV-1M pol sequences from Equatoguinean subjects attending Spanish clinics during 1997-2011, and 83 additional sequences sampled in GQ in 1997 and 2008 from GenBank. All (n = 278) were re-classified using phylogeny and tested for drug-resistance mutations. To evaluate the origin of CRF02_AG in GQ, we analyzed 2,562 CRF02_AG sequences and applied Bayesian MCMC inference (BEAST program).ResultsMost Equatoguinean patients recruited in Spain were women (61.1%) or heterosexuals (87.7%). In the 278 sequences, the variants found were CRF02_AG (47.8%), A (13.7%), B (7.2%), C (5.8%), G (5.4%) and others (20.1%). We found 6 CRF02_AG clusters emerged from 1983.9 to 2002.5 with origin in GQ (5.5 sequences/cluster). Transmitted drug-resistance (TDR) rate among naïve patients attended in Spain (n = 144) was 4.7%: 3.4% for PI (all with M46IL), 1.8% for NRTI (all with M184V) and 0.9% for NNRTI (Y188L). Among pre-treated patients, 9/31 (29%) presented any resistance, mainly affecting NNRTI (27.8%).ConclusionsWe report a low (<5%) TDR rate among naïve, with PI as the most affected class. Pre-treated patients also showed a low drug-resistance prevalence (29%) maybe related to the insufficient treatment coverage in GQ. CRF02_AG was the prevalent HIV-1M variant and entered GQ through independent introductions at least since the early 1980s.
Highlights
The human immunodeficiency virus type 1 group M (HIV-1M), responsible for the HIV pandemic, originated from a zoonotic transmission from chimpanzees into humans in Cameroon [1]
HIV-1 group M (HIV-1M) is sub-divided into 9 pure subtypes (A-D, F-H, J and K) and recombinants between them: 58 circulating recombinant forms (CRFs) and multiple unique recombinant forms (URFs)
The epidemiological information was not available in the 83 sequences retrieved from GenBank and sampled in Equatorial Guinea
Summary
The human immunodeficiency virus type 1 group M (HIV-1M), responsible for the HIV pandemic, originated from a zoonotic transmission from chimpanzees into humans in Cameroon [1]. Equatorial Guinea (GQ), a Spanish colony until 1968, is a small country located in West Central Africa between Cameroon and Gabon. Close to the epicenter of HIV-1 pandemic, only two local studies [4,5] have so far reported the HIV molecular epidemiology in GQ. Djoko et al evaluated 41 HIV-1M pol sequences sampled in 2008 from military personnel in Malabo 2the capital city. Both studies revealed CRF02_AG as the prevalent HIV-1M variant, as happens in the neighboring countries [6]. The HIV epidemic is increasing in Equatorial Guinea (GQ), West Central Africa, but few studies have reported its HIV molecular epidemiology. We aimed to describe the HIV-1 group M (HIV-1M) variants and drug-resistance mutations in GQ using sequences sampled in this country and in Spain, a frequent destination of Equatoguinean migrants
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