Emergence of HIV-1 Unique DG Recombinant Form in Pakistan

After the first case of HIV infection in 1987, the number of cases has continuously increased in Pakistan, turning from isolated incidents to outbreaks to the concentrated epidemic. The HIV epidemic in Pakistan is mainly driven by subtype A; however, the overlapping transmission chains facilitate recombination between subtypes and existing circulating recombinants forms (CRFs), leading to the emergence of unique recombinant forms (URFs). In this study, we report the first case of a URF (URF_DG) in a Pakistani HIV-infected patient. Phylogenetic and drug resistance analysis of the patient-derived sequence indicated that Pakistani URF_DG sequence was closely related to the URF_DG sequence reported from the United Kingdom, but had more drug resistance mutations than the U.K. sequence.