Abstract
BackgroundIn Africa, the wide genetic diversity of HIV has resulted in emergence of new strains, rapid spread of this virus in sub-Saharan populations and therefore spread of the HIV epidemic throughout the continent.MethodsTo determine the prevalence of antibodies to HIV among a high-risk population in Gabon, 1098 and 2916 samples were collected from pregnant women in 2005 and 2008, respectively. HIV genotypes were evaluated in 107 HIV-1-positive samples to determine the circulating subtypes of strains and their resistance to antiretroviral drugs (ARVs).ResultsThe seroprevalences were 6.3% in 2005 and 6.0% in 2008. The main subtype was recombinant CRF02_AG (46.7%), followed by the subtypes A (19.6%), G (10.3%), F (4.7%), H (1.9%) and D (0.9%) and the complex recombinants CRF06_cpx (1.9%) and CRF11_cpx (1.9%); 12.1% of subtypes could not be characterized. Analysis of ARVs resistance to the protease and reverse transcriptase coding regions showed mutations associated with extensive subtype polymorphism. In the present study, the HIV strains showed reduced susceptibility to ARVs (2.8%), particularly to protease inhibitors (1.9%) and nucleoside reverse transcriptase inhibitors (0.9%).ConclusionsThe evolving genetic diversity of HIV calls for continuous monitoring of its molecular epidemiology in Gabon and in other central African countries.
Highlights
In Africa, the wide genetic diversity of HIV has resulted in emergence of new strains, rapid spread of this virus in sub-Saharan populations and spread of the HIV epidemic throughout the continent
Anti-Human immunodeficiency virus type 1 (HIV-1) prevalence Antibodies to HIV were found in 69 of 1098 pregnant women tested in 2005 (6.3%; 95% CI, 4.9-7.7) and 174 of 2916 in 2008 (6.0%; 95% CI, 5.7-6.3) (Table 1)
Our results show that widely genetically diverse HIV-1 strains are circulating among untreated pregnant women in Gabon, including pure subtypes (A, D, F, G, H), a unique recombinant form (CRF02_AG) and complex recombinant forms (CRF06_cpx, CRF11_cpx)
Summary
In Africa, the wide genetic diversity of HIV has resulted in emergence of new strains, rapid spread of this virus in sub-Saharan populations and spread of the HIV epidemic throughout the continent. Most HIV-1 infections are observed in Africa, where the widest genetic diversity has been described [2]. Studies in the past decade showed increasing genetic diversity of HIV-1 in Gabon, central Africa [7,8,9,10]. In 2000, Makuwa et al demonstrated a predominance of subtype A (49%) in the general population, with a number of unclassified HIV-1 strains (13%) [8]. A high proportion of subtypes (30%) were found discordant, indicating a complex genetic composition of these circulating HIV-1 strains in Gabon. A further study from our laboratory confirmed stable circulation of CRF02_AG (63%) among migrant populations, and for the first time, demonstrated the presence of the complex recombinant form CRF11_cpx [9]
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