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Polotan FGM, Salazar CRP, Morito HLE, Abulencia MFB, Pantoni RAR, Mercado ES, Hué S, Ditangco RA. Reconstructing the phylodynamic history and geographic spread of the CRF01_AE-predominant HIV-1 epidemic in the Philippines from PR/RT sequences sampled from 2008 to 2018. Virus Evol 2023; 9:vead073. [PMID: 38131006 PMCID: PMC10735293 DOI: 10.1093/ve/vead073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
The Philippines has had a rapidly growing human immunodeficiency virus (HIV) epidemic with a shift in the prevalent subtype from B to CRF01_AE. However, the phylodynamic history of CRF01_AE in the Philippines has yet to be reconstructed. We conducted a descriptive retrospective study reconstructing the history of HIV-1 CRF01_AE transmissions in the Philippines through molecular epidemiology. Partial polymerase sequences (n = 1144) collected between 2008 and 2018 from three island groups were collated from the Research Institute for Tropical Medicine drug resistance genotyping database. Estimation of the time to the most recent common ancestor (tMRCA), effective reproductive number (Re), effective viral population size (Ne), relative migration rates, and geographic spread of CRF01_AE was performed with BEAST. Re and Ne were compared between CRF01_AE and B. Most CRF01_AE sequences formed a single clade with a tMRCA of June 1996 [95 per cent highest posterior density (HPD): December 1991, October 1999]. An increasing CRF01_AE Ne was observed from the tMRCA to 2013. The CRF01_AE Re reached peaks of 2.46 [95 per cent HPD: 1.76, 3.27] in 2007 and 2.52 [95 per cent HPD: 1.83, 3.34] in 2015. A decrease of CRF01_AE Re occurred in the intervening years of 2007 to 2011, reaching as low as 1.43 [95 per cent HPD: 1.06, 1.90] in 2011, followed by a rebound. The CRF01_AE epidemic most likely started in Luzon and then spread to the other island groups of the country. Both CRF01_AE and Subtype B exhibited similar patterns of Re fluctuation over time. These results characterize the subtype-specific phylodynamic history of the largest CRF01_AE cluster in the Philippines, which contextualizes and may inform past, present, and future public health measures toward controlling the HIV epidemic in the Philippines.
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Affiliation(s)
- Francisco Gerardo M Polotan
- Molecular Biology Laboratory, Research Institute for Tropical Medicine, 9002, Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, Metro Manila 1781, The Philippines
| | - Carl Raymund P Salazar
- Laboratory of Microbiology, Wageningen University and Research, Stippeneng 4, Wageningen 6700 EH, The Netherlands
| | - Hannah Leah E Morito
- Molecular Biology Laboratory, Research Institute for Tropical Medicine, 9002, Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, Metro Manila 1781, The Philippines
| | - Miguel Francisco B Abulencia
- Molecular Biology Laboratory, Research Institute for Tropical Medicine, 9002, Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, Metro Manila 1781, The Philippines
| | - Roslind Anne R Pantoni
- Molecular Biology Laboratory, Research Institute for Tropical Medicine, 9002, Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, Metro Manila 1781, The Philippines
| | - Edelwisa S Mercado
- Molecular Biology Laboratory, Research Institute for Tropical Medicine, 9002, Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, Metro Manila 1781, The Philippines
| | - Stéphane Hué
- Centre for the Mathematical Modelling of Infectious Diseases (CMMID), London School of Hygiene & Tropical Medicine, Keppel Street, London, Camden WC1E 7HT , UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, Camden WC1E 7HT , UK
| | - Rossana A Ditangco
- AIDS Research Group, Research Institute for Tropical Medicine, 9002, Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, Metro Manila 1781, The Philippines
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Abad CL, Bello JAG, Cruz AB, Danilovic A, Elias J, Bremer JW, Huang DD. Prevalent subtypes and one-year outcomes of an HIV-cohort from an urban Philippine center. Medicine (Baltimore) 2021; 100:e28315. [PMID: 34941127 PMCID: PMC8701963 DOI: 10.1097/md.0000000000028315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Circulating HIV subtypes in the Philippines have increasingly diversified, potentially affecting treatment. We monitored outcomes of a treatment-naïve cohort and their virus subtype prevalence.Retrospective/prospective study cohort.HIV-I-REACT clinic patients co-enrolled in the Virology Quality Assurance Program (RUSH-VQA) from 7/2017-6/2019 were included. Relevant demographic and laboratory information were collected. The ViroSeq HIV-1 Genotyping System v.3 and HIV-1 Integrase Genotyping Kit identified protease-reverse transcriptase and integrase drug resistance mutations (DRM). Sequence subtyping followed using the Stanford University Drug Resistance Database and the REGA HIV-1 Subtyping Tool v.3. The jpHMM HIV-1 Tool and REGA HIV-1 Subtyping Tool provided additional subtype analysis of this cohort's 5'LTR-VIF regions after Sanger sequencing. One-year outcomes included virologic suppression, mortality, and follow-up.86/88 patients were males. Median age was 30 (range 19-65) years; 61/88 were MSM. 15/85 carried baseline DRM. ViroSeq-generated sequences included subtypes CRF01_AE (66/85), B (14/85), and newer recombinants (4/85). Extensive sequencing (n = 71) of the 5'-LTR-GAG-Pol genes showed CRF01_AE (n = 50), subtype B (n = 7), and other recombinants (n = 13). Bootstrap analysis identified 7 pairs of highly related strains. Discordant DRM appeared in 2/7 pairs, where 1/2 strains displayed DRM. After 1 year, 87 individuals were alive, with 19 lost to care. Viral load (VL) was repeated for only 31/77 (40.2%). Follow-up CD4 testing for 39/77 (50.6%) showed an increase to a median of 327 cells/mm3.Our cohort currently carries subtype CRF01_AE (∼68%-70%), followed by subtype B and CRF01_AE/B recombinants. Outcomes were favorable, regardless of subtype after 1 year on cART.
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Affiliation(s)
- Cybele L. Abad
- Department of Medicine, Section of Infectious Diseases, The Medical City, Ortigas Ave, Pasig, Philippines
- Department of Medicine, Division of Infectious Diseases, University of the Philippines Manila, Philippine General Hospital, Taft Avenue Manila, Philippines
| | - Jia An G. Bello
- Department of Medicine, Section of Infectious Diseases, The Medical City, Ortigas Ave, Pasig, Philippines
| | - Angela Beatriz Cruz
- Department of Medicine, Section of Infectious Diseases, The Medical City, Ortigas Ave, Pasig, Philippines
| | - Aleksandra Danilovic
- Department of Microbial Pathogens and Immunology, Rush University Medical College, 1653 West Congress Parkway, Chicago, IL
| | - Juan Elias
- Department of Microbial Pathogens and Immunology, Rush University Medical College, 1653 West Congress Parkway, Chicago, IL
| | - James W. Bremer
- Department of Microbial Pathogens and Immunology, Rush University Medical College, 1653 West Congress Parkway, Chicago, IL
| | - Diana D. Huang
- Department of Microbial Pathogens and Immunology, Rush University Medical College, 1653 West Congress Parkway, Chicago, IL
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Salvana EMT, Samonte GMJ, Telan E, Leyritana K, Tactacan-Abrenica RJ, Ching PR, Arevalo GM, Dungca NT, Peñalosa-Ramos C, Mendoza KAR, Trinidad LF, Tonga AD, Lim J, Destura R, Alejandria M, Solante R, Arcangel L, Palaypayon NS, Schwem BE. High rates of tenofovir failure in a CRF01_AE-predominant HIV epidemic in the Philippines. Int J Infect Dis 2020; 95:125-132. [PMID: 32081778 DOI: 10.1016/j.ijid.2020.02.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The Philippines has the fastest growing HIV epidemic in the Asia-Pacific. This increase was accompanied by a shift in the predominant HIV subtype from B to CRF01_AE. Increasing evidence points to a difference in treatment responses between subtypes. We examined treatment failure and acquired drug resistance (ADR) in people living with HIV (PLHIVs) after one year on antiretrovirals (ARVs). METHODS PLHIV maintained on ARVs for one year were recruited. Treatment failure was defined as a viral load of ≥1000 copies/mL. Sanger sequencing for genotyping and drug resistance mutation (DRM) detection was performed on patients failing treatment. RESULTS 513 PLHIV were enrolled. The most common antiretroviral regimens were TDF+3TC + EFV (269) and AZT+3TC + EFV (155). 53 (10.3%) subjects failed treatment. Among these, 48 (90.6%) had DRMs, 84.9% were subtype CRF01_AE. Tenofovir-based regimens performed worse than zidovudine-based regimens (OR 3.28, 95% CI 1.58-7.52 p < 0.001). Higher rates of NRTI, NNRTI, K65R tenofovir resistance, and multi-class resistance were found compared to those reported in literature. CONCLUSIONS HIV treatment failure at one year of treatment in the Philippines is 10.3%. We found unusually high tenofovir and multiclass resistance, and optimal ARV regimens may need to be reevaluated for CRF01_AE-predominant epidemics.
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Affiliation(s)
- Edsel Maurice T Salvana
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Genesis May J Samonte
- HIV Surveillance Unit, Epidemiology Bureau, Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila 1003, Philippines
| | - Elizabeth Telan
- STD/AIDS Cooperative Central Laboratory, Bldg 17 San Lazaro Hospital, Quiricada St., Sta. Cruz, Manila 1003, Philippines
| | - Katerina Leyritana
- Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong City, Philippines
| | | | - Patrick R Ching
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
| | - Geraldine M Arevalo
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Niña Theresa Dungca
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Christine Peñalosa-Ramos
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
| | - Kevin Anthony R Mendoza
- HIV Surveillance Unit, Epidemiology Bureau, Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila 1003, Philippines
| | - Lyka F Trinidad
- HIV Surveillance Unit, Epidemiology Bureau, Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila 1003, Philippines
| | - Angelo Dela Tonga
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Jodor Lim
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
| | - Raul Destura
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Marissa Alejandria
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
| | - Rontgene Solante
- H4-Out Patient Department, San Lazaro Hospital, Quiricada St., Sta. Cruz, Manila 1003, Philippines
| | - Lalaine Arcangel
- H4-Out Patient Department, San Lazaro Hospital, Quiricada St., Sta. Cruz, Manila 1003, Philippines
| | - Noel S Palaypayon
- HIV Surveillance Unit, Epidemiology Bureau, Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila 1003, Philippines
| | - Brian E Schwem
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines.
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Chen Y, Hora B, DeMarco T, Berba R, Register H, Hood S, Carter M, Stone M, Pappas A, Sanchez AM, Busch M, Denny TN, Gao F. Increased predominance of HIV-1 CRF01_AE and its recombinants in the Philippines. J Gen Virol 2019; 100:511-522. [PMID: 30676308 PMCID: PMC7011713 DOI: 10.1099/jgv.0.001198] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/20/2018] [Indexed: 12/28/2022] Open
Abstract
The growth rate of new HIV infections in the Philippines was the fastest of any countries in the Asia-Pacific region between 2010 and 2016. To date, HIV-1 subtyping results in the Philippines have been determined by characterizing only partial viral genome sequences. It is not known whether recombination occurs in the majority of unsequenced genome regions. Near-full-length genome (NFLG) sequences were obtained by amplifying two overlapping half genomes from plasma samples collected between 2015 and 2017 from 23 newly diagnosed infected individuals in the Philippines. Phylogenetic analysis showed that the newly characterized sequences were CRF01_AE (14), subtype B (3), CRF01/B recombinants (5) and a CRF01/CRF07/B recombinant (1). All 14 CRF01_AE formed a tight cluster, suggesting that they were derived from a single introduction. The time to the most recent common ancestor (tMRCA) for CRF01_AE in the Philippines was 1995 (1992-1998), about 10-15 years later than that of CRF01_AE in China and Thailand. All five CRF01/B recombinants showed distinct recombination patterns, suggesting ongoing recombination between the two predominant circulating viruses. The identification of partial CRF07_BC sequences in one CRF01/CRF07/B recombinant, not reported previously in the Philippines, indicated that CRF07_BC may have been recently introduced into that country from China, where CRF07_BC is prevalent. Our results show that the major epidemic strains may have shifted to an increased predominance of CRF01_AE and its recombinants, and that other genotypes such as CRF07_BC may have been introduced into the Philippines.
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Affiliation(s)
- Yue Chen
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Bhavna Hora
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Todd DeMarco
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Regina Berba
- I-REACT Clinic, Section of Infectious Diseases, Department of Medicine, The Medical City, 1605 Pasig City, Philippines
| | - Heidi Register
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Sylvia Hood
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Meredith Carter
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Mars Stone
- Blood Systems Research Institute, San Francisco, CA 94118, USA
| | - Andrea Pappas
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Ana M. Sanchez
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Michael Busch
- Blood Systems Research Institute, San Francisco, CA 94118, USA
| | - Thomas N. Denny
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
| | - Feng Gao
- Department of Medicine, Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA
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Gangcuangco LMA, Sawada I, Tsuchiya N, Do CD, Pham TTT, Rojanawiwat A, Alejandria M, Leyritana K, Yokomaku Y, Pathipvanich P, Ariyoshi K. Regional Differences in the Prevalence of Major Opportunistic Infections among Antiretroviral-Naïve Human Immunodeficiency Virus Patients in Japan, Northern Thailand, Northern Vietnam, and the Philippines. Am J Trop Med Hyg 2017; 97:49-56. [PMID: 28719295 PMCID: PMC5508895 DOI: 10.4269/ajtmh.16-0783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 02/22/2017] [Indexed: 11/07/2022] Open
Abstract
To identify regional differences in the distribution of opportunistic infections (OIs) among human immunodeficiency virus (HIV)-infected patients in Asia, the medical records of antiretroviral therapy (ART)-naïve patients who attended the following tertiary hospitals from 2003 to 2011 were reviewed: Nagoya Medical Center (NMC, Nagoya, Japan), Lampang Hospital (LPH, Lampang, northern Thailand), Bach Mai Hospital (BMH, Hanoi, northern Vietnam), and Philippine General Hospital (PGH, Manila, Philippines). Logistic regression analyses were performed to identify associations between country of origin and risk of major OIs. In total, 1,505 patients were included: NMC, N = 365; LPH, N = 442; BMH, N = 384; and PGH, N = 314. The median age was 32 years, and 73.3% of all patients were male. The median CD4 count was 200 cells/μL. Most patients at NMC and PGH were men who have sex with men. Injection drug users were most common at BMH (35.7%). Mycobacterium tuberculosis (TB) was most common at PGH (N = 75) but was rare at NMC (N = 4). Pneumocystis pneumonia (PCP) prevalence was highest at NMC (N = 74) and lowest at BMH (N = 13). Multivariable logistic regression showed increased odds of TB at PGH (adjusted odds ratio [aOR] = 42.2, 95% confidence interval [CI] = 14.6-122.1), BMH (aOR = 12.6, CI = 3.9-40.3), and LPH (aOR = 6.6, CI = 2.1-21.1) but decreased odds of PCP at BMH (aOR = 0.1, CI = 0.04-0.2) and LPH (aOR = 0.2, CI = 0.1-0.4) compared with those at NMC. The cryptococcosis risk was increased at LPH (aOR = 6.2, CI = 0.9-41.0) compared with that at NMC. Cytomegalovirus (CMV) retinitis prevalences were similar in all countries. OI prevalence remained high among ART-naïve patients in our cohort. The risks of TB, PCP, and cryptococcosis, but not CMV retinitis, differed between countries. Improved early HIV detection is warranted.
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Affiliation(s)
- Louie Mar A. Gangcuangco
- Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
- Bridgeport Hospital-Yale New Haven Health, Bridgeport, Connecticut
| | - Ikumi Sawada
- Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
| | - Naho Tsuchiya
- Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | | | | | | | - Marissa Alejandria
- Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Katerina Leyritana
- Philippine General Hospital, University of the Philippines, Manila, Philippines
| | | | | | - Koya Ariyoshi
- Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
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Salvaña EMT, Schwem BE, Ching PR, Frost SDW, Ganchua SKC, Itable JR. The changing molecular epidemiology of HIV in the Philippines. Int J Infect Dis 2017; 61:44-50. [PMID: 28602726 DOI: 10.1016/j.ijid.2017.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/25/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The Philippines has one of the fastest-growing HIV epidemics in the world. Possible reasons for this include increased testing, increased local transmission, and possibly more aggressive strains of HIV. This study sought to determine whether local molecular subtypes of HIV have changed. METHODS Viruses from 81 newly diagnosed, treatment-naive HIV patients were genotyped using protease and reverse transcriptase genes. Demographic characteristics and CD4 count data were collected. RESULTS The cohort had an average age of 29 years (range 19-51 years), CD4+ count of 255 cells/mm3 (range 2-744 cells/mm3), and self-reported acquisition time of 2.42 years (range 0.17-8.17 years). All were male, including 79 men who have sex with men (MSM). The genotype distribution was 77% CRF01_AE, 22% B, and 1% C. Previous data from 1985-2000 showed that most Philippine HIV infections were caused by subtype B (71%, n=100), followed by subtype CRF01_AE (20%). Comparison with the present cohort showed a significant shift in subtype (p<0.0001). Comparison between CRF01_AE and B showed a lower CD4+ count (230 vs. 350 cells/mm3, p=0.03). Survival data showed highly significant survival associated with antiretroviral (ARV) treatment (p<0.0001), but no significant difference in mortality or CD4 count increase on ARVs between subtypes. CONCLUSIONS The molecular epidemiology of HIV in the Philippines has changed, with the more aggressive CRF01_AE now being the predominant subtype.
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Affiliation(s)
- Edsel Maurice T Salvaña
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, Manila 1000, Philippines; Infectious Disease Section, Philippine General Hospital, Manila 1000, Philippines
| | - Brian E Schwem
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, Manila 1000, Philippines.
| | - Patrick R Ching
- Infectious Disease Section, Philippine General Hospital, Manila 1000, Philippines
| | - Simon D W Frost
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Sharie Keanne C Ganchua
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, Manila 1000, Philippines
| | - Jill R Itable
- Infectious Disease Section, Philippine General Hospital, Manila 1000, Philippines
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Bagashev A, Sawaya BE. Roles and functions of HIV-1 Tat protein in the CNS: an overview. Virol J 2013; 10:358. [PMID: 24359561 PMCID: PMC3879180 DOI: 10.1186/1743-422x-10-358] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/06/2013] [Indexed: 01/01/2023] Open
Abstract
Nearly 50% of HIV-infected individuals suffer from some form of HIV-associated neurocognitive disorders (HAND). HIV-1 Tat (a key HIV transactivator of transcription) protein is one of the first HIV proteins to be expressed after infection occurs and is absolutely required for the initiation of the HIV genome transcription. In addition to its canonical functions, various studies have shown the deleterious role of HIV-1 Tat in the development and progression of HAND. Within the CNS, only specific cell types can support productive viral replication (astrocytes and microglia), however Tat protein can be released form infected cells to affects HIV non-permissive cells such as neurons. Therefore, in this review, we will summarize the functions of HIV-1 Tat proteins in neural cells and its ability to promote HAND.
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Affiliation(s)
| | - Bassel E Sawaya
- Molecular Studies of Neurodegenerative Diseases Lab, The Fels Institute for Cancer Research & Molecular Biology, Philadelphia, PA 19140, USA.
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Yin L, Liu L, Sun Y, Hou W, Lowe AC, Gardner BP, Salemi M, Williams WB, Farmerie WG, Sleasman JW, Goodenow MM. High-resolution deep sequencing reveals biodiversity, population structure, and persistence of HIV-1 quasispecies within host ecosystems. Retrovirology 2012; 9:108. [PMID: 23244298 PMCID: PMC3531307 DOI: 10.1186/1742-4690-9-108] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 11/20/2012] [Indexed: 02/05/2023] Open
Abstract
Background Deep sequencing provides the basis for analysis of biodiversity of taxonomically similar organisms in an environment. While extensively applied to microbiome studies, population genetics studies of viruses are limited. To define the scope of HIV-1 population biodiversity within infected individuals, a suite of phylogenetic and population genetic algorithms was applied to HIV-1 envelope hypervariable domain 3 (Env V3) within peripheral blood mononuclear cells from a group of perinatally HIV-1 subtype B infected, therapy-naïve children. Results Biodiversity of HIV-1 Env V3 quasispecies ranged from about 70 to 270 unique sequence clusters across individuals. Viral population structure was organized into a limited number of clusters that included the dominant variants combined with multiple clusters of low frequency variants. Next generation viral quasispecies evolved from low frequency variants at earlier time points through multiple non-synonymous changes in lineages within the evolutionary landscape. Minor V3 variants detected as long as four years after infection co-localized in phylogenetic reconstructions with early transmitting viruses or with subsequent plasma virus circulating two years later. Conclusions Deep sequencing defines HIV-1 population complexity and structure, reveals the ebb and flow of dominant and rare viral variants in the host ecosystem, and identifies an evolutionary record of low-frequency cell-associated viral V3 variants that persist for years. Bioinformatics pipeline developed for HIV-1 can be applied for biodiversity studies of virome populations in human, animal, or plant ecosystems.
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Affiliation(s)
- Li Yin
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, 2033 Mowry Road, PO Box 103633, Gainesville, FL 32610-3633, USA.
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Molina RM, Torina AG, Biffi K, Bismara BAP, Albuquerque DM, Andrade PD, Anjos EBV, Toro ADC, Nolasco MT, Vilela MMS, Costa SCB. Prevalence of HIV-1 Subtypes in Brazilian Children With Perinatally Acquired Infection. ACTA ACUST UNITED AC 2009; 8:106-12. [DOI: 10.1177/1545109709331808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
HIV-1 infection has increased among women in recent years. The HIV-1 env gene (structural gene) has the greatest variation in all the HIV gene regions. In this study, 58 samples from infants infected with HIV-1 via perinatal transmission were analyzed. All the 58 samples were submitted to Nested-polymerase chain reaction of the env gene region for posterior viral genotyping using EN 70 and EN 85 (first polymerase chain reaction) and EN 80 and EN 95 (second polymerase chain reaction) primers, with the product of the 682 base pair amplification. After Nested-polymerase chain reaction for genotyping, purification of the product, and direct sequencing in a MegaBace 1000 automatic sequencer, 56 genotypes were found in the 58 HIV-1-positive children of the study, where 47 (83.93%) were HIV-1 subtype B infected and 9 (16.07%) were HIV-1 subtype F1 infected. The results demonstrate the predominance of subtype B followed by subtype F in Southeast Brazil.
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Affiliation(s)
- Rosana M. Molina
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Anali G. Torina
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Keila Biffi
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Beatriz A. P. Bismara
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Dulcineia M. Albuquerque
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Paula D. Andrade
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Emanuel B. V. Anjos
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Adleia D. C. Toro
- Department of Pediatrics, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Marcos T. Nolasco
- Department of Pediatrics, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Maria M. S. Vilela
- Department of Pediatrics, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Sandra C. B. Costa
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil,
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10
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Agdamag DM, Kageyama S, Alesna ET, Solante RM, Leaño PS, Heredia AML, Abellanosa-Tac-An IP, Vibal ET, Jereza LD, Ichimura H. Rapid spread of hepatitis C virus among injecting-drug users in the Philippines: Implications for HIV epidemics. J Med Virol 2005; 77:221-6. [PMID: 16121359 DOI: 10.1002/jmv.20439] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
From the trends of human immunodeficiency virus (HIV) epidemics in South and Southeast Asia, it was postulated that an HIV epidemic would start as a blood-borne infection among injecting-drug users in the Philippines. In 2002, 560 individuals were recruited in Metro Cebu, Philippines and tested for HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) infections. The seroprevalence of anti-HCV among injecting-drug users (70.1%, 61/87) was significantly higher than those among inhalation drug users (16.3%, 7/43; P = 0.00; OR = 12), sex workers (0%, 0/130; P = 0.00; OR = infinity), antenatal clinic attendees (0%, 0/100; P = 0.00; OR = infinity), and students/health care workers (2%, 4/200; P = 0.00; OR = 115). The seroprevalence of HBsAg among injecting-drug users (10.3%, 9/87) was significantly higher than those among sex workers (2.3%, 3/130; P = 0.01; OR = 4.9), and antenatal clinic attendees (3%, 3/100; P = 0.04; OR = 3.7), but was not statistically different from those among inhalation drug users (9.3%, 4/43; P = 0.9) and students/health care workers (4.5%, 9/200; P = 0.06). None of the study population was reactive to anti-HIV antibody. The HCV strains obtained from the injecting-drug users belonged to either genotype 1a or 2b and the strains in each genotype clustered closely to each other. There was no dual infection with genotype 1a and 2b. These results suggest that the HCV infection in injecting-drug users may be emanating rapidly from limited number individuals in Metro Cebu, Philippines.
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Affiliation(s)
- Dorothy M Agdamag
- STD AIDS Cooperative Central Laboratory, San Lazaro Hospital, Manila, Philippines
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11
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Abstract
HIV (ie, HIV-1) epidemics in Asia show great diversity, both in severity and timing. But epidemics in Asia are far from over and several countries including China, Indonesia, and Vietnam have growing epidemics. Several factors affect the rate and magnitude of growth of HIV prevalence, but two of the most important are the size of the sex worker population and the frequency with which commercial sex occurs. In view of the present state of knowledge, even countries with low prevalence of infection might still have epidemics affecting a small percentage of the population. Once HIV infection has become established, growing needs for care and treatment are unavoidable and even the so-called prevention-successful countries of Thailand and Cambodia are seeing burgeoning care needs. The manifestations of HIV disease in the region are discussed with the aim of identifying key issues in medical management and care of HIV/AIDS. In particular, issues relevant to developing appropriate highly active antiretroviral treatment programmes in the region are discussed. Although access to antiretroviral therapy is increasing globally, making it work effectively while simultaneously expanding prevention programmes to stem the flow of new infections remains a real challenge in Asia. Genuine political interest and commitment are essential foundations for success, demanding advocacy at all levels to drive policy, mobilise sufficient resources, and take effective action.
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Affiliation(s)
- Kiat Ruxrungtham
- Faculty of Medicine, Chulalongkorn University, the Thai Red Cross AIDS Research Centre and HIV-NAT, Bangkok 10330, Thailand
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12
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Abstract
Genetic diversity is a hallmark of HIV-1 infection with regard to the expansion of distinct viral subtypes (clades A, B, C, D, E, F, G, K, and O) in different geographical regions. Here, we discuss the issues of HIV-1 sensitivity to antiretroviral drugs and drug resistance in the context of HIV-1 subtype diversity. Virtually all available evidence suggests that all subtypes of HIV display similar sensitivity to antiviral drugs, but viruses from some subtypes or geographical regions may occasionally have a greater propensity to develop resistance against certain drugs than other viral variants. In some situations, the types of mutations associated with resistance may vary, as a result of subtle differences among subtypes with regard to the genetic code. This consideration notwithstanding, drug resistance is unlikely to become a more serious issue in developing than developed countries, and there is an urgency to make anti-HIV drugs available to all who are in need.
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Affiliation(s)
- Mark A Wainberg
- McGill University AIDS Centre, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.
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13
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Herring BL, Ge YC, Wang B, Ratnamohan M, Zheng F, Cunningham AL, Saksena NK, Dwyer DE. Segregation of human immunodeficiency virus type 1 subtypes by risk factor in Australia. J Clin Microbiol 2004; 41:4600-4. [PMID: 14532189 PMCID: PMC254314 DOI: 10.1128/jcm.41.10.4600-4604.2003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to determine which human immunodeficiency virus type 1 (HIV-1) subtypes were circulating in Australia and to correlate the subtypes with risk factors associated with the acquisition of HIV-1 infection. DNA was extracted from peripheral blood mononuclear cells, and HIV-1 env genes were amplified and subtyped using heteroduplex mobility analysis, with selected samples sequenced and phylogenetic analysis performed. The HIV-1 env subtypes were determined for 141 samples, of which 40 were from female patients and 101 were from male patients; 13 samples were from children. Forty-seven patients were infected by homosexual or bisexual contact, 46 were infected through heterosexual contact, 21 were infected from injecting drug use (IDU), 13 were infected by vertical transmission, 8 were infected from nosocomial exposure, and 6 were infected by other modes of transmission, including exposure to blood products, ritualistic practices, and two cases of intrafamilial transmission. Five subtypes were detected; B (n = 104), A (n = 5), C (n = 17), E (CRF01_AE; n = 13), and G (n = 2). Subtype B predominated in HIV-1 acquired homosexually (94% of cases) and by IDU (100%), whereas non-subtype B infections were mostly seen in heterosexually (57%) or vertically (22%) acquired HIV-1 infections and were usually imported from Africa and Asia. Subtype B strains of group M viruses predominate in Australia in HIV-1 transmitted by homosexual or bisexual contact and IDU. However, non-B subtypes have been introduced, mostly acquired via heterosexual contact.
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Affiliation(s)
- Belinda L Herring
- Center for Virus Research, Westmead Millennium Institute, Westmead Hospital, Westmead, NSW 2145, Australia
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14
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Brodine SK, Starkey MJ, Shaffer RA, Ito SI, Tasker SA, Barile AJ, Tamminga CL, Stephan KT, Aronson NE, Fraser SL, Wallace MR, Wegner SA, Mascola JR, McCutchan FE. Diverse HIV-1 subtypes and clinical, laboratory and behavioral factors in a recently infected US military cohort. AIDS 2003; 17:2521-7. [PMID: 14600525 DOI: 10.1097/00002030-200311210-00016] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe the demographics, risk behaviors, and HIV-1 subtypes in a large cohort of recently HIV-infected military personnel. DESIGN Descriptive, cross-sectional study. METHODS US military personnel with recent HIV seroconversion from six medical referral centers were enrolled with a self-administered questionnaire, CD4 cell counts, syphilis and hepatitis B serologies, plasma viral RNA levels, and HIV-1 subtype nucleic acid sequencing. RESULTS Between February 1997 and May 2000, 520 patients were enrolled. Most [488 (94.3%)] were infected with HIV-1 subtype B. The most prevalent non-B subtype was a circulating recombinant form (CRF01_AE) [17 (61%)]; however, two pure subtypes (C and D), as well as CRF02_AG, CRF09_cpx and a BE recombinant were identified. The likely area of HIV-1 acquisition was the United States for 70% of the volunteers. At least three non-B subtype infections (two subtype C, one subtype CRF01_AE) were apparently acquired domestically. Risk behaviors and comorbid sexually transmitted diseases were reported during the seroconversion period. Volunteers with non-B subtype HIV infection were more likely to report heterosexual contacts [92% vs. 39%; odds ratio (OR), 10.0], including contacts with commercial sex workers (41% vs. 13%; OR, 4.9). The Roche Amplicor version 1.0 assay was less sensitive for non-B subtype infections than the Roche Amplicor version 1.5 assay. CONCLUSION There is a high prevalence and diversity of non-B HIV subtypes in this large cohort. Efficient diagnosis of acute primary HIV-1 infection was identified as a goal for prevention programs. Modifiable risk behaviors and target populations for intervention were identified.
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Affiliation(s)
- Stephanie K Brodine
- Graduate School of Public Health, San Diego State University, San Diego, California 92182, USA
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15
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Leaño PS, Kageyama S, Espantaleon A, Maniar J, Iwasaki M, Saple D, Yoshihara N, Kurimura T, Agdamag DM. Introduction of human immunodeficiency virus type 2 infection in the Philippines. J Clin Microbiol 2003; 41:516-8. [PMID: 12517912 PMCID: PMC149589 DOI: 10.1128/jcm.41.1.516-518.2003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to describe and document the first case of human immunodeficiency virus type 2 (HIV-2) in the Philippines by using serological and molecular techniques and to compare the diversity of this strain to that of strains from other countries. With the introduction of HIV-2 into the country and the presence of diversified strains of HIV-1, the use of highly sensitive assays to detect all these strains is recommended.
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Affiliation(s)
- Prisca Susan Leaño
- STD AIDS Cooperative Central Laboratory, San Lazaro Hospital, Manila, Philippines
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16
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Foley B, Donegan E, Silitonga N, Wignall FS, Busch MP, Delwart EL. Importation of multiple HIV type 1 strains into West Papua, Indonesia (Irian Jaya). AIDS Res Hum Retroviruses 2001; 17:1655-9. [PMID: 11779353 DOI: 10.1089/088922201753342068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV-1 from 16 sexually transmitted disease clinic patients in Timika, West Papua, Indonesia was amplified by RT-PCR and subtyped by a combination of envelope and gag region heteroduplex mobility analysis (HMA) and direct PCR DNA sequencing. HMA showed the presence of 14 subtype E (CRF01_AE) and 2 subtype B HIV-1. Phylogenetic analysis of a 540-bp V3-V4 region of gp120 showed that 9 of 10 CRF01_AE variants clustered tightly with a median distance of 1.3% (range, 0.5 to 2.2%) whereas 1 CRF01_AE variant diverged significantly from the others (median distance, 10.7%; range, 10.1 to 11.8%). One subtype B virus envelope was typical of United States/European strains whereas the other appeared to be related to Thai subtype B' variants. These results reflect the independent introduction of multiple HIV-1 strains into West Papua, with the rapid spread in the majority of infected patients tested of a single strain of HIV-1E (CRF01_AE).
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Affiliation(s)
- B Foley
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, New Mexico 87501, USA
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17
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Chen MY, Lee CN. Molecular epidemiology of HIV-1: an example of Asia. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2001; 49:417-36. [PMID: 11013770 DOI: 10.1016/s1054-3589(00)49033-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- M Y Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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18
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Liitsola K, Ristola M, Holmström P, Salminen M, Brummer-Korvenkontio H, Simola S, Suni J, Leinikki P. An outbreak of the circulating recombinant form AECM240 HIV-1 in the Finnish injection drug user population. AIDS 2000; 14:2613-5. [PMID: 11101077 DOI: 10.1097/00002030-200011100-00028] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- K Liitsola
- Department of Infectious Disease Epidemiology, National Public Health Institute, Helsinki, Finland
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20
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Casado C, Urtasun I, Martín-Walther MV, García S, Rodríguez C, del Romero J, López-Galíndez C. Genetic analysis of HIV-1 samples from Spain. J Acquir Immune Defic Syndr 2000; 23:68-74. [PMID: 10708058 DOI: 10.1097/00126334-200001010-00009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To characterize the viruses responsible for the HIV-1 epidemic in Spain, we genetically characterized 79 samples obtained from Spanish patients with different risk practices (injecting drug users and male homosexuals) in two regions (Madrid and Navarra). Genetic characterization was carried out by nucleotide sequencing in the C2-V3-C3 region and by phylogenetic analysis. All samples were of subtype B except one that clustered with clade F. Because no segregation of samples was determined according to the risk group of patients nor to their geographic origin, the Spanish samples analyzed constitute a single group of viruses. These data, along with the starlike topology of the phylogenetic tree, support the existence of a single introduction of HIV-1 subtype B in Spain. The mean genetic distance among subtype B sequences was of 13.9%+/-0.06% (range, 5%-25%), suggesting an epidemic of long evolution. Analysis of sequences in relation to isolation dates revealed an increase in the heterogeneity of the nucleotide sequences with time. According to these data, a divergence rate of 0.49%+/-0.11% per year was calculated for the Spanish samples during the period analyzed.
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Affiliation(s)
- C Casado
- Centro Nacional de Biología Fundamental, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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21
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Mori H, Otake T, Oishi I, Kurimura T. Characterization of human immunodeficiency virus type 1 resistant to modified cyclodextrin sulphate (mCDS71) in vitro. Antivir Chem Chemother 1999; 10:15-21. [PMID: 10079875 DOI: 10.1177/095632029901000102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Drug resistance of human immunodeficiency virus type 1 (HIV) to modified cyclodextrin sulphate (mCDS71) has been analysed with respect to both the in vitro appearance of resistance to the compound and the mechanism of the acquisition of resistance. Resistant strains could be obtained in all three strains (NL432, KK-1 and A018) tested after serial passages in MT-4 cells with a gradual increase of the concentration of mCDS71. Cross-resistance both to mCDS71 and dextran sulphate 8000 was observed. As a result of sequencing analysis of the gp120 V3-C5 region of resistant strains, the mechanism of resistance can be explained in several ways: (i) substitution of sugar chain-binding amino acids, N and S; (ii) three to five amino acid deletion in V4 loop; and (iii) several mutations in V3 and V4 regions. The real cause of the resistance may be a combination of these three mechanisms. The results suggest that the target of mCDS71 is relatively widely distributed on the viral surface glycoprotein.
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Affiliation(s)
- H Mori
- Osaka Prefectural Institute of Public Health, Japan.
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Chen J, Young NL, Subbarao S, Warachit P, Saguanwongse S, Wongsheree S, Jayavasu C, Luo CC, Mastro TD. HIV type 1 subtypes in Guangxi Province, China, 1996. AIDS Res Hum Retroviruses 1999; 15:81-4. [PMID: 10024057 DOI: 10.1089/088922299311754] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Chen
- Guangxi AIDS Surveillance and Testing Center, Nanning, PR China
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