Introduction of HIV-2 and multiple HIV-1 subtypes to Lebanon

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• Understanding HIV genetic variability is crucial for tracking transmission and developing effective interventions.
• Lebanon, a region not traditionally considered endemic for diverse HIV subtypes, was investigated for its HIV genetic landscape.
• Previous studies have not fully characterized the extent of HIV genetic diversity and subtype distribution in Lebanon.

Purpose of the Study:

• To analyze the genetic variability, phylogenetic relationships, and transmission dynamics of HIV in Lebanese patients.
• To identify the subtypes of Human Immunodeficiency Virus (HIV) circulating in Lebanon.
• To assess the implications of observed HIV genetic diversity for public health, including blood safety and vaccine development.

Main Methods:

• Phylogenetic analysis of HIV env-C2-V3 gene sequences from 26 HIV-infected patients.
• Identification of HIV-1 and HIV-2 subtypes.
• Analysis of viral genetic regions to detect potential recombinants.
• Epidemiologic correlation of patient travel histories and behavioral risks with identified HIV strains.

Main Results:

• Twenty-five HIV-1 strains and one HIV-2 strain (subtype B) were identified.
• HIV-1 strains were classified into subtypes B, A, C, D, G, and unclassifiable, with subtypes B and A being the most prevalent.
• Three patients harbored potential HIV recombinants, indicating complex viral genetic exchange.
• Identified HIV subtypes correlated with strains prevalent in countries visited by patients or their partners, suggesting imported transmission.

Conclusions:

• The study reveals a complex distribution of HIV subtypes and recombinants in Lebanon, suggesting global spread of diverse strains.
• Recommendations include enhanced blood screening for both HIV-1 and HIV-2 in Lebanon to ensure blood supply safety.
• The characterized HIV genetic data can inform the development of more broadly effective HIV vaccines.