Abstract
Phylogenetic studies have suggested that the HIV-1 epidemic in the Americas is mainly dominated by HIV subtype B. However, countries of South America and the Caribbean have recently reported changes in their circulating HIV-1 genetic profiles. The aim of this study was to characterize the molecular profile of the HIV-1 epidemic in Panama by the analysis of 655 polymerase gene (pol) sequences that were obtained from HIV-infected Panamanians diagnosed between 1987 and 2013. Blood samples were collected from recently infected, antiretroviral drug-naïve and treatment-experienced subjects since mid-2007 to 2013. Viral RNA from plasma was extracted and sequences of HIV protease and reverse transcriptase genes were obtained. Bootscanning and phylogenetic methods were used for HIV subtyping and to trace the putative origin of non-B subtype strains. Our results showed that HIV-1 infections in Panama are dominated by subtype B (98.9%). The remaining 1.1% is represented by a diverse collection of recombinant variants including: three URFs_BC, one CRF20_BG, and one CRF28/29_BF, in addition to one subtype F1 and one subtype C, none of which were previously reported in Panama. The non-B subtype variants detected in Panama were probably introduced from Brazil (subtype F1 and CRF28/29_BF), Cuba (CRF20_BG), Dominican Republic (URFs_BC) and India (subtype C). Panama is the geographical vertex that connects the North with South America and the Caribbean through trade and cultural relations, which may explain the observed introductions of non-B subtype HIV-1 variants from both the Caribbean and South America into this Central American country.
Highlights
The Human Immunodeficiency Virus (HIV) is the causative agent of Acquired Immune Deficiency Syndrome (AIDS)
At the beginning of the Panamanian epidemic, the majority of the infections had occurred between men who have sex with men (MSM); since 1991, there has been an increase in the number of infected women [5,6]
29 years after the first diagnosed HIV case in Panama, this molecular epidemiology research represents the largest study to date on HIV subtype distribution in the country
Summary
The Human Immunodeficiency Virus (HIV) is the causative agent of Acquired Immune Deficiency Syndrome (AIDS). The Panamanian HIV/AIDS epidemic has changed dramatically. At the beginning of the Panamanian epidemic, the majority of the infections had occurred between men who have sex with men (MSM); since 1991, there has been an increase in the number of infected women [5,6]. Even though the total HIV prevalence has decreased from 1.4% to 0.8% in the general population since 2001 and the prevalence among female sex workers remains low (0.7–1.6%) [7], the prevalence among MSM continues to steadily increase and reached 23% in 2011 [8]. A higher prevalence of HIV infections among MSM in the Americas was only observed in Jamaica (38%) [8]
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