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Published on: August 31, 2014
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.
Abstract:
In 2019, an outbreak of HIV infection predominantly affecting children occurred in Larkana district, Pakistan. This is the largest outbreak ever reported in this age group in Pakistan. In this study, we report two HIV-1 unique recombinant forms identified during the outbreak. Blood samples were collected from HIV-positive children as part of a case-control study to investigate the outbreak. The pol gene was sequenced and used to detect HIV subtype/recombinant forms using subtype, recombination, and phylogenetic analyses. Drug resistance mutation (DRM) analysis was performed to characterize the DRMs in each sequence. We observed the emergence of two unassigned unique recombinant forms related to CRF36_cpx in 15 individuals of the 344 samples collected. Genotype analysis revealed the presence of multiple DRMs associated with resistance to reverse transcriptase inhibitors. The discovery of these unassigned unique recombinant forms in our population highlights the need for comprehensive molecular epidemiological studies to fully understand the distribution and drug resistance patterns to aid control efforts.
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