Travel and the introduction of human immunodeficiency virus type 1 non-B subtype genetic forms into Western countries

Area de Patogenia Viral, Centro Nacional de Biología Fundamental, Instituto de Salud Carlos III, Madrid, Spain.
Clinical Infectious Diseases (Impact Factor: 9.42). 07/2001; 32(12):1732-7. DOI: 10.1086/320764
Source: PubMed

ABSTRACT Both high mutation rates and recombination contribute to the genetic diversity of human immunodeficiency virus type 1 (HIV-1). Among viruses of the main group, which are responsible for the HIV-1 pandemic, 21 circulating genetic forms have been reported, 11 of which are recombinant between > or = 2 subtypes. In Western Europe and the Americas, the HIV-1 epidemic is largely dominated by B subtype viruses; however, infections with diverse non-B subtype genetic forms are increasingly being recognized. In Western Europe and North America, most of them have been identified in immigrants or travelers returning from areas with high HIV-1 prevalence, mainly from sub-Saharan Africa and Southeast Asia, where non-B subtype genetic forms predominate, but propagation within other groups has been reported in some Western countries. This may have implications for prophylactic and therapeutic strategies and, by bringing in contact different genetic forms, may favor the generation of novel recombinant viruses. Travelers from different categories--including immigrants, military personnel, seamen, tourists, expatriates, diplomats, and businessmen--may be at risk of transporting HIV non-B subtype genetic forms to Western countries.

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    • "Majority of patients carrying non B subtype strains were infected through heterosexual contact and this association was found to be statistically significant. Numerous studies have shown that non-B infections in Europe are mainly associated with heterosexual infection among immigrants or persons epidemiologically linked to sub-Saharan Africa (Gifford et al., 2006; Thomson and Nájera, 2001). In contrast to that finding, vast majority of patients in our study reported to be infected locally, with no epidemiological links abroad. "
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    • "The growth of interest in the study of subtype differences is likely a result of the fact that large numbers of patients infected with non-B viral subtypes are now being exposed to ARVs for the first time through the Global Fund and PEPFAR programs. In addition, recent years have shown rising numbers of non-B infections in North America and Europe as the epidemic has become increasingly globalized (Thomson and Najera, 2001). These shifts have sparked concern "
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