Increasing prevalence of non-clade BHIV-1 strains in heterosexual men and women, as monitored by analysis of reverse transcriptase and protease sequences
(2001) JAIDS — Vol. 27, n° 5, p. 499-505 (2001)
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- Objective: We evaluated the prevalence of HIV-1 non-clade B over time in a formerly clade B-restricted area. Protease and reverse transcriptase regions of the pot gene were used for phylogenetic and recombination analysis and for clade assignment to HIV-1 A-D, F-H, J, and K strains of the M group. Methods: The pot gene of 349 HIV-1 patients belonging to the Italian Cohort Naive for Antiretrovirals (ICONA) were genotypically analyzed to study the prevalence of antiretroviral-associated resistance mutations. All HIV-1 pot sequences and 32 HIV reference strains were analyzed, including the reference strains for the major HIV-1 subtypes. The non-clade B sequences according to the HIV-1 Subtyping Tool program were further studied by a bootscan analysis (SimPlot) to investigate the likelihood of recombination between subtypes. Results: Phylogenetic analysis detected 19 of 349 (5.4%) non-clade B subtypes. The proportions of patients carrying non-clade B virus before and after 1997 were 1.9% and 8.4%, respectively (p = .008). Among whites, heterosexual infection and female gender were significantly associated with the presence of non-clade B subtypes (p = .001 and .005, respectively). Non-clade B HIV-1 was harbored by 14.5% of the heterosexuals who were found to be HIV-1 positive after 1997, 60% of whom were women. Bootscan analysis identified four strains as F, two as A, one as C, one as G, and 11 (57.9 %) as non-clade B recombinant subtypes. Conclusion: Detection of HIV-1 subtypes and intersubtype recombinants in a previously clade B-homogeneous area indicates that the HIV-1 epidemic is evolving in Italy and that heterosexuals and women are at increased risk of infection with non-clade B HIV-1 subtypes. Sequences inferred from the pot gene yield to establish the subtype of circulating HIV-1 strains. As a consequence, genotyping of pot gene for testing resistance to antiretrovirals warrants concomitant surveillance of non-clade B subtypes.
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Balotta, C., Facchi, G., Violin, M., Van Dooren, S., Cozzi-Lepri, A., Forbici, F., Bertoli, A., Riva, C., Senese, D., Caramello, P., Carnevale, G., Rizzardini, G., Cremonini, L., Monno, L., Rezza, G., Perno, C., Ippolito, G., d’Arminio-Monforte, A., Vandamme, AM., & Moroni, M. (2001). Increasing prevalence of non-clade BHIV-1 strains in heterosexual men and women, as monitored by analysis of reverse transcriptase and protease sequences. JAIDS, 27(5), 499-505. https://doi.org/10.1097/00126334-200108150-00012 (Original work published 2001)