Extensive Genetic Diversity of HIV-1 in Incident and Prevalent Infections among Malaysian Blood Donors: Multiple Introductions of HIV-1 Genotypes from Highly Prevalent Countries

Abstract

Transfusion-transmissible infections including HIV-1 continue to pose major risks for unsafe blood transfusions due to both window phase infections and divergent viruses that may not be detected by donor screening assays. Given the recent emergence of several HIV-1 circulating recombinant forms (CRFs) in high-risk populations in the Southeast Asia region, we investigated the genetic diversity of HIV-1 among the blood donors in Kuala Lumpur, Malaysia. A total of 211 HIV-positive plasma samples detected among 730,188 donations to the National Blood Centre between 2013 and 2014 were provided (90.5% male, median age: 27.0 years old). Recent or long-term infection status at the time of donation was determined using a limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA). HIV-1 gag-pol genes were amplified and sequenced from residual plasma for 149 cases followed by genotype determination using phylogenetic and recombination analyses. Transmitted antiretroviral resistance mutations were not observed among the blood donors, among which 22.7% were classified as recent or incident infections. Major circulating HIV-1 genotypes determined by neighbour-joining phylogenetic inference included CRF01_AE at 40.9% (61/149), CRF33_01B at 21.5% (32/149), and subtype B at 10.1% (15/149). Newly-described CRFs including CRF54_01B circulated at 4.0%, CRF74_01B at 2.0%, and CRF53_01B and CRF48_01B at 0.7% each. Interestingly, unique HIV-1 genotypes including African subtype G (8.7%), CRF45_cpx (1.3%), CRF02_AG (0.7%) and CRF07_BC (0.7%) from China were detected for the first time in the country. A cluster of subtype G sequences formed a distinct founder sub-lineage within the African strains. In addition, 8.7% (13/149) of HIV-infected donors had unique recombinant forms (URFs) including CRF01_AE/B' (4.7%), B'/C (2.7%) and B'/G (1.3%) recombinants. Detailed analysis identified similar recombinant structures with shared parental strains among the B'/C and B'/G URFs, some of which were sequenced from recently infected individuals, indicating the possible emergence and on-going spread of foreign clades of CRF candidates among the local population. The findings demonstrate extensive molecular complexity of HIV-1 among the infected blood donors in Malaysia, driven in part by the increased spread of recently described CRFs and multiple introductions of previously unreported genotypes from highly prevalent countries.

Prevalence and Molecular Epidemiology of Transmitted Drug Resistance and Genetic Transmission Networks Among Newly Diagnosed People Living With HIV/AIDS in a Minority Area, China

“…The proportion of recent infections (within 130 days) among all newly diagnosed PLWH was only 2.73% in this area, which also deserves concern. The proportion of recent infections was lower than that in other areas with a high rate of HIV in China (40,41) and those in other countries (40,42), indicating that most of the newly diagnosed PLWH were not detected in time. HIV might be spread by many individuals unaware of their infection, leading to a widespread of HIV in this area.…”

Genetic Diversity of HIV-1 and Transfusion Safety : Systematic Review and Concepts Analysis

“…Therefore, the conceptual analysis of this study made it possible to choose the viral load as the quantifiable variable par excellence of this study given its presence in several conceptual joints of viral transmission. It has also shown the involvement of the molecular components of HIV-1 on the residual risk in blood transfusion [20,21,22]. The serological markers (anti-HIV Ab, AgP24) identified as secondary variables to the concept by their presence throughout the infection would also contribute to the diagnosis of HIV-1 and the interpretation of recent or chronic infection [23].…”

Effectiveness of dog collars impregnated with 4% deltamethrin in controlling visceral leishmaniasis in Lutzomyia longipalpis (Diptera: Psychodidade: Phlebotominae) populations

“…The 4% deltamethrin-impregnated collar is currently considered a tool for VL control. Some studies have indicated that its use in transmission areas reduces the prevalence of canine VL, but these studies have not shown its effects on the vector population ( Kazimoto 2016 , Sevá et al 2016 ). This effect on the prevalence of canine VL is based on a reduction in blood feeding by the vector on dogs with collars, mediated by the repellent and insecticidal action of deltamethrin, a pyrethroid, impregnated in the collars ( Halbig et al 2000 , David et al 2001 , Maroli et al 2001 ).…”

“…Comparable results were reported by Kazimoto, who showed a 53% prevalence reduction with the use of these collars in a smaller number of dogs. In addition, a mathematical modelling study performed by Sevá et al (2016) indicated that the use of insecticide-impregnated collars, when 90% coverage is achieved, can decrease the prevalence of seropositive dogs and incidence of human VL cases to zero.…”