Unassigned Complex Unique Recombinant Forms Related to CRF36_cpx in Children Identified in an HIV-1 Outbreak in

Syed Hani Abidi1,2, Dilsha Siddiqui1, Syed Faisal Mahmood3

  • 1Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.

Insights

Two novel HIV-1 unique recombinant forms were identified in a large pediatric outbreak in Pakistan. These strains show drug resistance mutations, emphasizing the need for molecular epidemiology to control HIV spread.

Area of Science:

  • Virology
  • Molecular Epidemiology
  • Public Health

Background:

  • A significant outbreak of human immunodeficiency virus (HIV) infection primarily affecting children occurred in Larkana district, Pakistan, in 2019.
  • This event represented the largest pediatric HIV outbreak documented in Pakistan.

Purpose of the Study:

  • To identify and characterize the specific human immunodeficiency virus type 1 (HIV-1) strains involved in the Larkana outbreak.
  • To analyze drug resistance mutations within these identified strains to inform public health interventions.

Main Methods:

  • Blood samples were collected from HIV-positive children participating in a case-control study.
  • The pol gene was sequenced for HIV subtype and recombinant form identification using phylogenetic and recombination analyses.
  • Drug resistance mutation (DRM) analysis was conducted on all sequenced samples.

Main Results:

  • Two previously unassigned unique recombinant forms (URFs) of HIV-1, related to CRF36_cpx, were identified in 15 out of 344 collected samples.
  • Genotype analysis revealed the presence of multiple DRMs conferring resistance to reverse transcriptase inhibitors in these URFs.
  • Phylogenetic and recombination analyses confirmed the novelty and distinctness of these identified HIV-1 strains.

Conclusions:

  • The emergence of these unassigned URFs in the Pakistani pediatric population necessitates further molecular epidemiological investigation.
  • Understanding the distribution and drug resistance profiles of these novel strains is crucial for effective HIV control strategies.
  • This study underscores the importance of ongoing surveillance for novel HIV recombinants, particularly in outbreak settings.