The changing molecular epidemiology of HIV type 1 among northern Thai drug users, 1999 to 2002.

Journal Article (Journal Article)

CRF01_AE and subtype B have dominated the HIV-1 epidemic in Thailand since 1989. We reported a new circulating recombinant form of HIV-1, CRF15_01B, as well as other unique CRF01_AE/B recombinants among prevalent HIV infections in Thailand. We sought to study this challenging molecular picture through assessment of subtypes among recent HIV-1 seroconverters in northern Thai drug users. A total of 847 HIV-1 seronegative drug users (342 IDU and 505 non-IDU) were enrolled, from 1999 to 2002, in a prospective study; 39 HIV-1 incident cases were identified and characteristics were collected. The overall HIV-1 incidence rate was 2.54/100PY, but it was 10.0/100PY among male IDU. HIV was strongly associated with injection history; 38 of 39 seroconverters gave a history of IDU. A near full-length genome of HIV-1 was recovered by PCR amplification and sequenced from peripheral mononuclear cell extracted DNA of 38 seroconverters. Phylogenetic analysis revealed that 33 (86.8%) were CRF01_AE and 5 (13.2%) were CRF01_AE/B recombinants. These recombinants had different structure but shared some common breakpoints, indicating an ongoing recombination process. Recombinant infection increased with year of sampling (0 to 57.1%). The molecular epidemiology of HIV-1 among drug users in northern Thailand has thus entered a new era. CRF01_AE remains predominant while pure subtype B is becoming rare, and now a substantial component of the epidemic. These findings support the need for CRF01_AE and subtype B components in clade-matched vaccine strategies for Thai phase III trials. Ongoing molecular surveillance of circulating HIV-1 strains is imperative for the evaluation of HIV vaccine efficacy.

Full Text

Duke Authors

Cited Authors

  • Tovanabutra, S; Beyrer, C; Sakkhachornphop, S; Razak, MH; Ramos, GL; Vongchak, T; Rungruengthanakit, K; Saokhieo, P; Tejafong, K; Kim, B; De Souza, M; Robb, ML; Birx, DL; Jittiwutikarn, J; Suriyanon, V; Celentano, DD; McCutchan, FE

Published Date

  • May 2004

Published In

Volume / Issue

  • 20 / 5

Start / End Page

  • 465 - 475

PubMed ID

  • 15186520

International Standard Serial Number (ISSN)

  • 0889-2229

Digital Object Identifier (DOI)

  • 10.1089/088922204323087705

Language

  • eng

Conference Location

  • United States