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HIV-1 subtype diversity in Europe.

Miłosz Parczewski¹, Karol Serwin¹, Dimitros Paraskevis²

¹Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, Poland.

The Lancet. HIV

|June 10, 2026

Summary

This summary is machine-generated.

The human immunodeficiency virus type 1 (HIV-1) epidemic in Europe is diversifying beyond subtype B. This viral diversity impacts treatment resistance, particularly sub-subtype A6, and requires updated prevention and surveillance strategies.

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Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3

Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3

Published on: December 27, 2010

Area of Science:

Epidemiology
Virology
Public Health

Background:

Historically, subtype B dominated HIV-1 epidemics in Western and Central Europe.
The WHO European region now exhibits a complex mix of HIV-1 variants, including non-B subtypes, circulating recombinant forms (CRFs), and unique recombinant forms (URFs).
Subtype A, especially sub-subtype A6, is prevalent in Eastern Europe, contributing to the region's substantial HIV-1 burden.

Purpose of the Study:

To review the evolving epidemiology of HIV-1 variants across the WHO European region.
To highlight the implications of increasing HIV-1 genetic diversity on public health strategies.
To discuss how viral diversity influences treatment, prevention, and surveillance.

Main Methods:

Review of epidemiological data on HIV-1 subtypes and recombinant forms in Europe.
Analysis of trends in HIV-1 variant distribution across different European regions.
Synthesis of emerging clinical and laboratory findings related to viral diversity and treatment outcomes.

Main Results:

Significant diversification of HIV-1 beyond subtype B across Europe, with regional variations.
Sub-subtype A6 is dominant in Eastern Europe and shows potential for increased resistance to cabotegravir-based therapies.
Recombinant forms are increasingly recognized across all European regions, indicating ongoing viral evolution.

Conclusions:

Growing HIV-1 genetic diversity in Europe necessitates adaptive prevention, treatment, and surveillance strategies.
Understanding subtype dynamics is crucial for optimizing the effectiveness of current and future HIV interventions, including long-acting injectables and broadly neutralizing antibodies.
Regional surveillance efforts must account for the changing landscape of HIV-1 variants to effectively control the epidemic.