Travel and the introduction of human immunodeficiency virus type 1 non-B subtype genetic forms into Western countries
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.
- SourceAvailable from: Valentina Nikolic
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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. "
ABSTRACT: Worldwide HIV-1 pandemic is becoming increasingly complex, with growing heterogeneity of subtypes and recombinant viruses. Previous studies have documented HIV-1 subtype B as the predominant one in Serbia, with limited presence and genetic diversity of non B subtypes. In recent years, MSM transmission has become the most frequently reported risk for HIV infection among newly diagnosed patients in Serbia, but very little is known of the network structure and dynamics of viral transmission in this and other risk groups. To gain insight about the HIV-1 subtypes distribution pattern as well as characteristics of HIV-1 transmission clusters in Serbia, we analyzed the genetic diversity of the pol gene segment in 221 HIV-1- infected patients sampled during 2002-2011. Subtype B was found to still be the most prevalent one in Serbia, accounting for over 90% of samples, while greater diversity of other subtypes was found than previously reported, including subtypes G, C, A, F, CRF01 and CRF02. In total, 41.3% of analyzed subtype B sequences were found associated in transmission clusters/network, that are highly related with MSM transmission route.Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases 06/2013; 19. DOI:10.1016/j.meegid.2013.06.015 · 3.26 Impact Factor
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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 "
ABSTRACT: This article uses fieldwork conducted among North American and Ugandan HIV researchers to track the evolution of molecular HIV science in the global context. The recent initiation of programs funding free antiretroviral treatment in sub-Saharan Africa has both forestalled the deaths of millions of patients and brought molecular medicine to the continent on a massive scale. However, in the years leading up to this development, scientists and policymakers engaged in heated debates over whether HIV treatment in Africa could succeed, with many arguing that economic and 'cultural' factors would lead to missed pills and the rapid development of drug-resistant HIV strains. This article describes how the molecular 'maps' upon which knowledge claims about HIV were made (including claims about treatment and drug resistance) are based on HIV strains found primarily in patients in North America and Europe, and raises questions about what this implies for patients and scientists in Africa and other regions in the global South. Borrowing from the insights of critical geographers, I argue that our genetic maps of HIV are partial and contingent and reflect a 'molecular politics' in which the global inequalities of the AIDS epidemic are manifest at the most minute scale, embedded within the very materials and tools scientists use to study HIV. The consequences of this fact are at once clinical, political and epistemological. http://www.palgrave-journals.com/biosoc/journal/v6/n2/abs/biosoc201037a.htmlBioSocieties 11/2011; 637:142-166. DOI:10.1057/biosoc.2010.37 · 1.26 Impact Factor
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- "3. The high rate of replication, thereby favoring selection of drug resistant mutants while under combination antiretroviral therapy (cART). 4. Human beings are the exclusive hosts, therefore human sexual behavior indirectly boosts these characteristic traits of HIV and offers optimal conditions for its spread and ongoing evolution (Kandathil et al., 2005; Taylor et al., 2009; Esbjörnsson et al., 2010; Zhang et al., 2010), besides special situations with injecting drug users (IDUs), e.g., sharing vehicles like needles or syringes contaminated with HIV. 5. Its evolution is further pushed by the spread of different HIV type I subtypes through modern modes of " travel " (Gifford et al., 2007) thereby favoring the forming of CRFs by HIV superinfections with yet unknown sequelae (Thomson and Nájera, 2001; Blackard and Mayer, 2004; French et al., 2006; McCutchan, 2006; de Oliveira et al., 2010). Carter (2010a) mentioned Gurirab's words that " parliamentarians have a duty to protect the rights of all citizens, including people with HIV, " and " by placing restrictions on the travel and movement of people with HIV, we needlessly rob them of their dignity and equal rights. "
ABSTRACT: The new prevalence data regarding the estimated global number of human immunodeficiency virus positive (HIV+) cases, i.e., including people who are either aware or unaware of their HIV infection in 2010, lead many to wonder why the increase in incidence has reached today's unprecedented level and escalated within such a short time. This, in spite of prevention campaigns in countries affected by HIV/acquired immune deficiency syndrome (AIDS) with their urgent messages aimed at preventing HIV transmission by promoting changes in individual's behavior. This article analyzes the background of the prevention strategies, in particular their political, social and legal concepts in terms of human rights, and reveals traits of human behavior not considered thus far. A radical reappraisal is necessary, at social and legislative levels, as well as options additional to current concepts. When ethical issues come up, they become blamed for outmoded moralistic positions. However, ignoring the reality has led to dire consequences from prioritizing individual human rights over society's collective need to prevent the spread of HIV.Journal of Zhejiang University SCIENCE B 07/2011; 12(7):591-610. DOI:10.1631/jzus.B1000434 · 1.29 Impact Factor