Molecular Epidemiology of HIV-1 in African Countries: A Comprehensive Overview.

Marta Giovanetti,Alessandra Borsetti,Cristina Parolin,Massimo Ciccozzi

doi:10.3390/pathogens9121072

Abstract

The human immunodeficiency virus type 1 (HIV-1) originated in non-human primates in West-central Africa and continues to be a major global public health issue, having claimed almost 33 million lives so far. In Africa, it is estimated that more than 20 million people are living with HIV/Acquired Immunodeficiency Syndrome (AIDS) and that more than 730,000 new HIV-1 infections still occur each year, likely due to low access to testing. The high genetic variability of HIV-1, due to a fast replication cycle and high mutation rate, may cause the generation of many viral variants in a single infected patient during a single day. Therefore, the active monitoring and characterization of the HIV-1 subtypes and recombinant forms circulating through African countries poses a significant challenge to more specific diagnoses, treatments, care, and intervention strategies. In this review, a concise characterization of all the subtypes and recombinant forms circulating in Africa is presented to highlight the magnitude of the HIV-1 threat among the African countries and to understand virus genetic diversity and dispersion dynamics better.

Highlights

The Human Immunodeficiency Virus type 1 (HIV-1) is one of the world’s most serious public health challenges [1,2]
Despite new HIV-1 infections having been reduced by 23% since 2010, Sub-Saharan Africa remains the most affected region, accounting for an estimated 69% of all people living with HIV Acquired Immunodeficiency Syndrome (AIDS), where gender-based violence and inequalities continue to drive the epidemic [1,2,4,5,6]
In African countries, 25.7 million people are infected with HIV-1, which accounts for almost two-thirds of the global total of new HIV-1 infections

Summary

Introduction

The Human Immunodeficiency Virus type 1 (HIV-1) is one of the world’s most serious public health challenges [1,2]. Soon after the HIV-1 epidemic began, the virus dispersed globally, its progress enhanced by stigma discrimination and widespread inequalities that are currently a major barrier to ending Acquired Immunodeficiency Syndrome (AIDS) [1,2,3]. It is rapidly expanding into geographic areas that were relatively spared from the epidemic and strengthening its presence in countries where. Despite new HIV-1 infections having been reduced by 23% since 2010, Sub-Saharan Africa remains the most affected region, accounting for an estimated 69% of all people living with HIV AIDS, where gender-based violence and inequalities continue to drive the epidemic [1,2,4,5,6]. This review aims to summarize the distribution of HIV-1 subtypes and recombinant forms in African countries

HIV Origin

HIV-1 Genetic Diversity

HIV-1 Subtypes and Recombinants

Percentageof of the the cumulative occurrence for each subtype over theover

Summary

Findings

Conclusions