AIDS (London, England) · 2026
HIV-1 variants in population-based national surveys in sub-Saharan Africa, 2015-2022.
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Ghys Peter D, Voetsch Andrew C, Justman Jessica E, Patel Hetal, DeVos Joshua R, Brown Kristin, Ussery Faith, Parekh Bharat, Mahy Mary, Abimiku Alash'le, Aliyu Sani, Aliyu Gambo, Zuma Khangelani, Moyo Sizulu, van der Walt Chéri, Kalimashe Monalisa N, Ndongmo Clement B, Kirungi Wilford L, Arimide Dawit A, Hemelaar Joris, the Study Group to characterize the HIV-1 variant distribution in national surveys in sub-Saharan Africa, 2015–2022
Аннотация
OBJECTIVE: To describe the distribution of HIV-1 variants in population-based national surveys conducted in sub-Saharan African countries between 2015 and 2022.
DESIGN: Multicountry analysis.
METHODS: Sixteen population-based national surveys, conducted between 2015 and 2022, were analyzed. Survey participants were eligible if HIV genotyping was successful. In most countries, people with HIV (PWH) with a recent infection, children with HIV younger than 18 months, and a country-specific selection of PWH with a non-recent infection were included. In Nigeria and South Africa, PWH were eligible when viral load >200 or >1000 RNA copies/ml, respectively. HIV-1 variants were identified using the REGA HIV-1 & 2 Automated Subtyping Tool version 3.0. The estimated distributions of HIV-1 variants for each survey were calculated as the percentage distribution.
RESULTS: The sample size varied between 42 and 1434 PWH per country survey. Country distributions showed great variation, with a majority of CRF02_AG in Cameroon, Côte d'Ivoire and Nigeria; a majority of subtype A in Kenya, Rwanda, and Uganda; near equal proportions of subtype C (39%) and subtype A (37%) in Tanzania, and dominance of subtype C (>90%) in Ethiopia, Eswatini, Lesotho, Malawi, Namibia, South Africa, Zambia, and Zimbabwe. Recombinant viruses were mostly found in countries in West-Africa.
CONCLUSIONS: The distribution of HIV-1 variants by country and region in sub-Saharan Africa showed important variation. HIV-1 diversity may need to be accounted for during the development of HIV diagnostic and viral load tests, vaccines, other prevention interventions, and treatment.
DESIGN: Multicountry analysis.
METHODS: Sixteen population-based national surveys, conducted between 2015 and 2022, were analyzed. Survey participants were eligible if HIV genotyping was successful. In most countries, people with HIV (PWH) with a recent infection, children with HIV younger than 18 months, and a country-specific selection of PWH with a non-recent infection were included. In Nigeria and South Africa, PWH were eligible when viral load >200 or >1000 RNA copies/ml, respectively. HIV-1 variants were identified using the REGA HIV-1 & 2 Automated Subtyping Tool version 3.0. The estimated distributions of HIV-1 variants for each survey were calculated as the percentage distribution.
RESULTS: The sample size varied between 42 and 1434 PWH per country survey. Country distributions showed great variation, with a majority of CRF02_AG in Cameroon, Côte d'Ivoire and Nigeria; a majority of subtype A in Kenya, Rwanda, and Uganda; near equal proportions of subtype C (39%) and subtype A (37%) in Tanzania, and dominance of subtype C (>90%) in Ethiopia, Eswatini, Lesotho, Malawi, Namibia, South Africa, Zambia, and Zimbabwe. Recombinant viruses were mostly found in countries in West-Africa.
CONCLUSIONS: The distribution of HIV-1 variants by country and region in sub-Saharan Africa showed important variation. HIV-1 diversity may need to be accounted for during the development of HIV diagnostic and viral load tests, vaccines, other prevention interventions, and treatment.