Global trends in molecular epidemiology of HIV-1 during 2000-2007

JORIS HEMELAAR; ELEANOR GOUWSB; PETER D. GHYSB; OSMANOV, SALADIN; HORACIO SALOMON (CONTRIBUTING MEMBER OF THE WHO-UNAIDS NETWORK FOR HIV ISOLATION AND CHARACTERISATION)

AIDS - AN INTERNATIONAL MONTHLY JOURNAL

LIPPINCOTT WILLIAMS & WILKINS

Año: 2011 vol. 25 p. 679 - 689

0269-9370

Objective: To estimate the global and regional distribution of HIV-1 subtypes and recombinants between 2000 and 2007.Design: Country-specific HIV-1 molecular epidemiology data were combined with estimates of the number of HIV-infected people in each country.Methods: Cross-sectional HIV-1 subtyping data were collected from 65 913 samples in 109 countries between 2000 and 2007. The distribution of HIV-1 subtypes in individual countries was weighted according to the number of HIV-infected people in each country to generate estimates of regional and global HIV-1 subtype distribution for the periods 2000-2003 and 2004-2007.Results: Analysis of the global distribution of HIV-1 subtypes and recombinants in the two periods indicated a broadly stable distribution of HIV-1 subtypes worldwide with a notable increase in the proportion of circulating recombinant forms (CRFs), a decrease in unique recombinant forms (URFs) and an overall increase in recombinants. In 2004-2007, subtype C accounted for nearly half (48%) of all global infections, followed by subtypes A (12%) and B (11%), CRF02_AG (8%), CRF01_AE (5%), subtype G (5%) and D (2%). Subtypes F, H, J and K together cause fewer than 1% of infections worldwide. Other CRFs and URFs are each responsible for 4% of global infections, bringing the combined total of worldwide CRFs to 16% and all recombinants (CRFs along with URFs) to 20%.Conclusion: The global and regional distributions of individual subtypes and recombinants are broadly stable, although CRFs may play an increasing role in the HIV pandemic. The global diversity of HIV-1 poses a formidable challenge to HIV vaccine development.