Printer Friendly

Genetic diversity of human immunodeficiency virus type 1 in the Democratic Republic of Congo: a review of available data.

Introduction

The Human Immunodeficiency Virus (HIV) has genetic diversity which is equal to the complexity of its management. The classification of types, groups, sub-groups, sub-sub-groups and different recombinant forms (CRFs-Circulating Recombinant Forms) or mutant allows for a better understanding of the virus, geographical distribution and evolution of the pandemic. (1-13) It also helped to better guide the management of patients infected with HIV. (2, 5, 10, 11) The Group M (Major) is the dominant group in Central Africa. (1-19) The distribution of this group in Africa and the Democratic Republic of Congo (DRC), in particular, is very heterogeneous, and it follows a specific and complex algorithm. (15-17) This distribution is highly dynamic, scalable and unpredictable and could continue to diversify as long as the virus circulates. (7) There is a very large group M genetic diversity in the sub-Saharan region of Africa. (1-21)

The first case of HIV group M has been documented from a blood sample collected in 1959 in Kinshasa, DR Congo (Leopoldville, Belgian Congo). (22) The DRC, located in the center of Africa, has the largest number of variants of HIV type 1, particularly in terms of group M subtypes, sub-subtypes and CRFs circulating throughout the country. (12, 17, 23, 24-41) With the development of molecular biology techniques in the field of diagnostic virology, classification of HIV strains is updated document and we see new strains circulating in different countries.

To determine the types, subtypes, sub-subtypes and CRFs circulating in DRC research genotyping strains have been made in recent years in some cities. These studies were conducted in Bukavu (South Kivu), (30) Bwamanda (Equateur province), (24) Kimpese (Bas Congo), (25) Kinshasa (Kinshasa province), (24) Kisangani (Orientale Province), (26, 30) Likasi (31) and Lubumbashi (26) (Katanga province), and Mbuji Mayi (Kasai Oriental). (24) These give us a geographical representation of partial strains circulating in DRC based on the territorial geography: East (Bukavu, Kisangani, Likasi, and Lubumbashi), West (Kinshasa Kimpese) and Centre (Bwamanda, Mbuji Mayi). In our context, the East includes the provinces of Katanga, Maniema, North Kivu, South Kivu and Orientale Province. The Center includes the provinces of Kasai Occidental, Kasai Oriental and Equateur. The West includes the provinces of Bandundu, Bas-Congo and Kinshasa.

The objective of this analysis is to review the specifics of the HIV epidemic in the Democratic Republic of Congo, in terms of molecular variants of human immunodeficiency virus in relation to geography published in the country.

Methods

We searched the literature and abstracts presented at conferences with the subject of interest to identify different variants of HIV type 1 in Democratic Republic of Congo (DRC). The research literature on these different strains was done on the internet websites following research: (i) MEDLINE / PubMed, (ii) POPLINE electronic database of published documents, (iii) data of access public articles presented at conferences, (iv) scientific report published on the Internet, (v) Google Scholar, and (vi) Cochrane Library. This online research was based on the following key words: "HIV subtype, DRC", "genotype, HIV, DRC" and "strains of HIV in the Democratic Republic of Congo".

The search was limited to published works and abstracts presented over the past 15 years (1997 to 2012). The manuscripts were selected according to the relevance of the results and the representativeness of the sample. The demographic information of the sample, measurement methods and objectives were considered in the evaluation of articles. Reading various articles allowed excluding items that do not relate directly circulating strains in the Democratic Republic of Congo.

Outcome analysis was made with SPSS version 17.0 for Windows. Student's t test and analysis of variance were used to compare and evaluate the different results. The results are expressed as a percentage and average percentage extremes [minimum-maximum].

Results

A literature search was performed by systematic interrogation of bibliographic databases and medical scientists over a period of 15 years. A step common to all studies is to systematically seek recommendations, systematic reviews, Meta-analyzes and other assessment work already published nationally and internationally. Several useful websites (government agencies, societies, etc.) were consulted.

Documents that were not accessible by conventional circuit dissemination of information (gray literature) were sought by other means available. The review of references cited in the articles analyzed to select items not identified during the interrogation of different sources of information.

Several manuscripts had as objective the identification of strains circulating in Democratic Republic of Congo (DRC).

According to the articles and abstracts of conferences published since 1997, we found a prevalence dominant group M (100%) and subgroup A 50.40% [31.2 to 68.9] in the throughout the DRC. In the East, influenza A (44.73%) are dominant strains C (12.20%), G (11.5%), D (9.12%) and G (7.24%) (Table 1). Centre, influenza A (62.57%) followed by strains C (10.32%), H (5.02%), U (4.3%) and D (3.9%) (Table 2). In the West, the influenza A (40.91%) are closely followed by strains G (19.29%), D (10.5%), F (5.65%) and C (4.51%) (Table 3).

For the whole country, the strains are found in the following order: A (49.40%), G (10.73%), C (9.01%) and D (7.86%) (Table 4). Differences within and between groups are statistically significant for the different strains (p> 0.001).

Figure 1 gives us a picture of the distribution of different variants of HIV type 1 in the country.

Discussion

This work was to identify the different variants of the Human Immunodeficiency Virus (HIV) circulating in the Democratic Republic of Congo (DRC) in the publications made since 1997. Several papers have been published as a direct objective the identification of different strains circulating in the DRC. Other work has been done to clarify on what had already been published by the same groups. Some others have addressed the genetic diversity of HIV in the DRC in general terms (continental or global).

To the east of the country to the towns of Bukavu (Bk) in the province of South Kivu, Kisangani (Ks) in the Eastern Province, Lubumbashi (Lu) and Likasi (Lk) in the province of Katanga, the group M is the most common. A variant is the most abundant with an average of 44.73% (53.0% in Bukavu, Kisangani 34.75% to 39.6% in Lubumbashi, Likasi 45.45%). The difference between the different prevalences of A is statistically significant (p> 0.001). Variant B was found in Bukavu and Kisangani respectively 1.2% and 4.8%. All other variants were found in this part of the country at different prevalences: C (Bk-18, 1%, 2-Ks, 78%, Lu-9, 4%, Lk-18, 2%), D (bk-1, 2%, 12-Ks, 3% Mo-13, 9%, Lk-9, 1%), F (bk-4, 8%, 3-Ks, 98% Mo-1, 4 % Lk-0), G (Bk-4, 8%, 21-Ks, 7%, Mo-10, 4%, Lk-9, 1%), H (Bk-1, 2%, 6-Ks , 5%, Mo-6, 25%, Lk-0), J (Bk-0, Ks-1, 2%, Mo-1, 4%, Lk-18, 2%), K (Bk-0, ks-0, Lu-2, 8% Lk-0) and U (Bk-13, 2%, 8-ks, 18% Mo-7, 6%, Lk-0). Intragroup differences in prevalence (p> 0.001) due to the location of cities, the influence of neighboring countries and the movement of populations in the region.

Center of the country, in the cities of Bwamanda (Bw) in the Province of Ecuador and MbujiMayi (Mb) in the province of Kasai Oriental, only group M variants circulating. A variant is dominant at 62.6% [55.8 to 68.9] (68.9% and 56.25% Bwamanda in Mbuji-Mayi). The difference between the different prevalence's of A is statistically significant (p> 0.001). Alternatives B (2.2%) and E (6.7%) were identified Bwamanda and not in Mbuji-Mayi. Variants C (20.65%), D (7.95%), G (2.8%), J (5.15%) and CRF02 AG (2.33%) have been described in Mbuji- Mayi without been found to Bwamanda. Variants F (Bw-2, 2% Mb-0, 85%), H (Bw-8, 9%, Mb-1, 15%), K (Bw-4, 4% Mb-0, 85 %) and U (Bw-6, 6%, Mb-2, 01%) were identified in two cities with statistically significant differences in prevalence (p> 0.001). Although the two cities are included in the central part of the country, is located north Bwamanda with border countries like the Republic of Congo and the Central African Republic while Mbuji-Mayi is situated in the south near the Katanga province and as a country with border of Angola.

To the west of the country to the cities of Kinshasa (Kn) in the province of Kinshasa and Kimpese (Kp) in the province of Bas Congo, group M is dominant. A variant is the dominant 40.91% [23.0 to 47.5] (34.32% and 47.5% in Kinshasa to Kimpese). The difference between the prevalence was statistically significant (p> 0.00). Variants J (1.66%), K (1.12%), U (3.48%), CRF01AE (4.95%), CRF02 AG (0.5%), CRF05 DF (0.35%) and CRF11_cpx (0.17%) present in Kinshasa are not identified Kimpese. Variants C (Kn-7, 42%, Kp-1, 6%), D (Kn- 11, 2%, Kp-9, 8%), E (Kn-0, 14%, Kp-3, 2 %), F (Kn-4, 8%%, Kp-6, 5%), G (Kn-17, 28%, Kp-21, 3%) and H (Kn-3, 89% 4-Kp 9%) were identified in the two cities. The difference in the prevalence of subgroup was significant (p> 0.001). Kinshasa has a greater diversity of strains compared to Kimpese. The latter is a rural town while Kinshasa is a city where there are people who come from the four corners of the country and even neighboring countries.

The subgroup B is more prevalent in Europe and North America. (1-13) Many publications do not mention it in Central Africa was affirmed by Huang et al (35) published in 2009 they did not detect the subgroup B in the Democratic Republic of Congo. While Vidal et al have published 2.4% of the sample Bwamanda infected with subgroup B in 1997 (24) and Eiji et al have published 4.8% for the subgroup B in Kisangani in 2006 and 1.2% in Bukavu in 2007. (30) Peeters et al published in 2003 only 0.4% of samples from the DRC subgroup B. (19) This discrepancy may be due to a factor of time, location and sampling.

The subgroup K is found in the DRC with an average of 2.25% [0.0 to 4.4] (Bwamanda-4, 4%, Kinshasa-1, 12% Lubumbashi-2, 8%, Mbuji Mayi-0.85%). This subgroup is rarely documented even in Central Africa. Kandathil et al in 2005 confirmed that this subgroup is unique to Cameroon and the DRC. (3)

The geographical distribution of HIV-1 variants in the DRC is closely related to the distribution of variants in neighboring countries. (26) Neighbors Northeast (Sudan (42), Uganda (15, 43-46), Rwanda (15, 47), Burundi (15, 48, 49)), the predominant strains are D, C, A and B. While in neighboring South East (Tanzania (15, 50, 51), Zambia (15, 52) and even Kenya (15, 52-54)), the dominant strains are A, C and D. This would explain the difference in prevalence between the East Kisangani / Bukavu and Lubumbashi north-east / south-east Likasi. The southern neighbor, Angola (15, 55-57), a dominance of strains A, C and H, which is reflected in Kinshasa and Kimpese. The western neighbor, the Republic of Congo (15, 58-60), a dominance of strains A, D and G, which is also reflected in Kinshasa and Kimpese. Neighbor of North, Central African Republic (15, 61, 62), a dominance of strains A, B, D and CRF01_AE is reflected on Bwamanda. The rural exodus (to major cities such as Kinshasa, Lubumbashi and Mbuji Mayi), the displacement of victims of war in the East as well as the movement of people across borders of the DRC makes this difficult to control pandemic for the country.

Conclusion

Several variants of HIV type 1 circulating through the Democratic Republic of Congo. Distribution is a mosaic, it is different depending on the province, the distribution in the country and the methods used. In general, the most prevalent strains (A, G, C and D) in the DRC are all Group M (Major). The high number of recombinant forms (CRFs) shows the diversity and dynamics of virus in this country. This diversity could quickly become a big problem for the fight against HIV in the DRC.

[FIGURE 1 OMITTED]

Acknowledgements: A part of this work has been partially presented at the 1st African Society of Laboratory Medicine (ASLM) International Conference 2012, South Africa, 1-7 December 2012.

Conflict of Interest: None declared.

References

(1.) Robert DL, Anderson JP, Bradac JA, Carr JK, Foley B, Funkhouser RK, Gao F, Hahn BH, Kalish ML, Kuiken C, Learn GH, Leitner T, McCutchan F, Osmanov S, Peeters M, Pieniazek D, Salminen M, Sharp PM, Wolinsky S, Korber B. HIV Type 1 nomenclature proposal. Science. 2000; 288: 55-6

(2.) McCutchan FE. Understanding the genetic diversity of HIV-1. AIDS. 2000; 14 (Suppl 3): S31-S44

(3.) Kandathil AJ, Ramalingam S, Kannagai R, David S and Sridharan G. Molecular epidemiology of HIV. Indian J Med Res. 2005; 121: 333-44

(4.) Requejo HI. Worldwide Molecular Epidemiology of HIV. Rev SaudePublica. 2006; 40 (2): 331-45

(5.) Takebe Y, Kusagawa S and Motomura K. Molecular Epidemiology of HIV: Tracking AIDS Pandemic. Pediatrics International. 2004; 46: 236-44.

(6.) Saragosti S. Epidemiologie moleculaire du VIH Type 1. Virologie. 1997; 1 (4):313-20.

(7.) Peeters M, Mulanga-Kabeya C et Delaporte E. La diversite genetique du VIH Type 1. Virologie. 2000; 4 (5): 371-881.

(8.) Barin F. La Diversite du Virus du SIDA. Biofutur. 1997; 169: 34-8.

(9.) Brun-Vezinet F, Damond F et Simon F. Variabilite des Virus de l'Immunodeficience Humaine de Type 1. Journee SPE du 13 Octobre 1999 a l'Institut Pasteur a Paris : "Genetique et Maladies Infectieuses dans l'environnement Tropical".

(10.) Thomson MM and Najera R. Molecular Epidemiology of HIV-1 Variants in the Global AIDS Pandemic: an Update. AIDS Reviews. 2005; 7: 210-24.

(11.) Thomson MM, Perez-Alvarez L and Najera R. Molecular Epidemiology of HIV-1 Genetic forms and its significance for Vaccine development and Therapy. The Lancet Infectious Diseases. 2002; 2: 46171.

(12.) Etienne L et Peeters M. Origine du VIH, une reussite emergentielle. Virologie. 2010; 14 (3): 171-83.

(13.) Hemelaar J, Gouws E, Ghys PD and Osmanov S. Global and Regional Distribution of HIV-1 Genetic Subtypes and Recombinants in 2004. AIDS. 2006; 20: W13-W23.

(14.) Shao Y, Williamson C. The HIV-1 Epidemic: Low- to Middle-Income Countries. Cold Spring HarbPerspectMed. 2012; 2: a007187.

(15.) Papathanasopoulos MA, Hunt GM and Tiemessen CT. Evolution and Diversity of HIV-1 in Africa: a Review. Virus Genes. 2003; 26 (2): 151-63.

(16.) Anglaret X and Salamon R. Epidemie de sida en Afrique Subsaharienne.M/S. 2004; 20 (5): 593-8.

(17.) Janssens W, Buve A, Nkengasong JN. The Puzzle of HIV-1 Subtypes in Africa. AIDS. 1997; 11: 70512.

(18.) Grandadam M, Nicand E, Koeck JL, Caron M, Teyssou R. Etat de la Resistance des Souches de VIH-1 en Afrique : Quelle Place pour les Reseaux de Surveillance Virologique ? Med. Trop. 2001; 61: 89-93.

(19.) Peeters M, Toure-Kane C, Nkengasong JN. Genetic diversity of HIV in Africa: impact on diagnosis, treatment, vaccine development and trials. AIDS. 2003; 17:2547-2560.

(20.) Roques P, Robertson DL, Souquiere S, Apetrei C, Nerrienet E, Barre- Sinoussi F, Muller-Trutwin M, Simon F. Phylogenetic characteristics of three new HIV-1 N strains and implications for the origin of group N. AIDS. 2004; 18: 1371-81.

(21.) Peeters M et al. Geographical Distribution of HIV-1 Groupe O viruses in Africa. AIDS. 1997; 11: 4938.

(22.) Zhu T, Korber BT, Nahmias AJ, Hooper E, Sharp PM, Ho DD. An African HIV-1 sequence from 1959, and implication for the origin of the epidemic. Nature. 1998; 391 (6667): 595-7.

(23.) Worobey M et al. Identification of a Complex env Subtype E HIV Type 1 Virus from the Democratic Republic of Congo, Recombinant with A, G, H, J, K, and Unknown Subtypes. Nature. 2008; 455: 6614.

(24.) Vidal N, Peeters M, Mulanga-Kabeya C, Nzilambi N, Robertson D, Ilunga W, Sema H, Tshimanga K, Bongo B, Delaporte E. Unprecedented degree of Humain Immunodeficiency Virus type 1 (HIV-1) group M genetic diversity in the Democratic Republic of Congo suggest that the HIV-1 pandemic originated in Central Africa. J Virol. 2000; 74: 10498-507.

(25.) Mokili JL, Wade CM, Burns SM, Cutting WAM, Bopopi JM, Green SDR, Peutherer JF, Simmonds P. Genetic heterogeneity of HIV type 1 subtypes in Kimpese, rural Democratic Republic of Congo. AIDS Res Hum Retroviruses. 1999; 15: 655-64.

(26.) Vidal N, Mulanga C, EdidiBazepeo S, Mwamba J, Tshimpaka JW, Kashi M, Mama N, Laurent C, Lepira F, Delaporte E, Peeters M. Distribution of HIV-1 Variants in the Democratic Republic of Congo Suggests Increase of Subtype C in Kinshasa Between 1997 and 2002. J AIDS. 2005; 40 (4): 456-62.

(27.) Yang C et al. Predominance of HIV Type 1 Subtype G among Commercial Sex Workers from Kinshasa, Democratic Republic of Congo. AIDS Res Hum Retroviruses. 2001; 17 (4): 361-65.

(28.) Yang C et al. Genetic Diversification and Recombination of HIV Type 1 Group M in Kinshasa, Democratic Republic of Congo. AIDS Res Hum Retroviruses. 2005; 21 (7): 661-666.

(29.) Djoko CF et al. High HIV Type 1 Group M pol Diversity and Low Rate of Antiretroviral Resistance Mutations Among the Uniformed Services in Kinshasa, Democratic Republic of the Congo. AIDS Res Hum Retroviruses. 2011; 27 (3): 323-9.

(30.) Eiji I et al. Molecular Epidemiology of HIV in Eastern Democratic Republic of Congo. Abstract, 5th Congres International des Pathologies Infectieuses et Parasitaires (5eme CIPP). 4-6 Novembre 2009 ; Kinshasa, Republique Democratique du Congo.

(31.) Kita K et al. Genetic Diversity of HIV Type 1 in Likasi, SouthEast of the Democratic Republic of Congo. AIDS Res Hum Retroviruses. 2004; 20 (12): 1352-7.

(32.) Vidal N et al. HIV Type 1 pol Gene Diversity and Antiretroviral Drug Resistance Mutations in the Democratic Republic of Congo (DRC). AIDS Res Hum Retroviruses. 2006; 22 (2): 202-6.

(33.) Vidal N, Mulanga C, Edidi-Bazepeo S, Lepira F, Delaporte E, Peeters M. Identification and Molecular Characterization of Sub subtype A4 in Central Africa. AIDS Res Hum Retroviruses. 2006; 22(2): 1827.

(34.) Mokili JL, Rogers M, Carr JK, Simmons P, Bopopi JM, Foley BT, Korber BT, Birx DL, McCutchan FE. Identification of a Novel Clade of Human Immunodeficiency Virus Type 1 in Democratic Republic of Congo. AIDS Res Hum Retroviruses. 2002; 18 (11): 817-23.

(35.) Huang DD, Foley BT, Tolzmann CA, Ouma A, Bremer J. Complex Mosaic Composition of Near Full Length Genomes of Two NED (NIH-ENVA-DOD) Subtype Panel HIV Type 1 Strains, BCF- Dioum and BCF-Kita, Originating from the Democratic Republic of Congo (DRC). Aids Res Hum Retroviruses. 2009; 25 (10): 1039-43.

(36.) Vidal N, Bazepeo SE, Mulanga C, Delaporte E, Peeters M. Genetic Characterization of Eight Full-Length HIV Type 1 Genomes from the Democratic Republic of Congo (DRC) Reveal a New Sub subtype, A5, in the A Radiation That Predominates in the Recombinant Structure of CRF26 A5U. AIDS Res Hum Retroviruses. 2009; 25 (8): 823-32.

(37.) Muwonga J et al. Resistance to Antiretroviral Drugs in Treated and Drug- Naive Patients in the Democratic Republic of Congo. JAcquir Immune DeficSyndr. 2011; 57 (1): S27-S33.

(38.) Duchet S, Letourneur F, Loussert-Ajaka I, Chaplain C, Gomas E, Brun- Vezinet F, Simon F, Saragosti S. gag and env sequences of an A/G/H recombinant from a Zairian HIV type 1 isolate. AIDS Res Hum Retroviruses. 1997; 13 (15): 1351-54.

(39.) Vidal N, Mulanga-Kabeya C, Nzilambi N, Delaporte E, Peeters M. Identification of a Complex env Subtype E HIV Type 1 Virus from the Democratic Republic of Congo, Recombinant with A, G, H, J, K, and Unknown Subtypes. AIDS Res Hum Retroviruses. 2000; 16 (18): 2059-64.

(40.) Montavon C, Vergne L, Bourgeois A, Mpoudi-Ngole E, Malonga-Mouellet G, Butel C, Toure-Kane C, Delaporte E, Peeters M. Identification of a New Circulating Recombinant Form of HIV Type 1, CRF11-cpx, Involving Subtypes A, G, J, and CRF01-AE, in Central Africa. AIDS Res Hum Retroviruses. 2002; 18 (3): 231-6.

(41.) Roques P, Robertson DL, Souquiere S, Apetrei C, Nerrienet E, Barre- Sinoussi F, Muller-Trutwin M, Simon F. Phylogenetic Characteristics of three new HIV-1 N Strains and Implications for the Origin of group N. AIDS. 2004; 18: 1271-81.

(42.) Hierholzer M et al. HIV Type 1 Strains from East and West Africa are intermixed in Sudan. AIDS Res Hum Retroviruses. 2002; 18 (15): 1163-6.

(43.) Hu DJ et al. Predominance of HIV-1 Subtype A and D Infections in Uganda. Emerging Infectious Diseases. 2000; 6 (6): 609-15.

(44.) Rayfield MA, Downing RG, James Baggs, Hu DJ, Pieniazek D, Luo CC, Biryahwaho B, Otten RA, Sempala SDK, Dondero TJ. A molecular epidemiologic survey of HIV in Uganda. HIV Variant Working Group. AIDS. 1998; 12: 521-7.

(45.) Collinson-Streng AN, Redd AD, Sewankambo NK, Serwadda D, Rezapour M, Lamers SL, Gray RH, Wawer MJ, Quinn TC, Laeyendecker O. Geographic HIV Type 1 Subtype Distribution in Rakai District, Uganda. AIDS Res Hum Retroviruses. 2009; 25 (10): 1045-48.

(46.) Kaleebu P, Whitworth J, Hamilton L, Rutebemberwa A, Lyagoba F, Morgan D, Duffield M, Biryahwaho B, Magambo B, Oram J. Molecular Epidemiology of HIV Type 1 in Rural Community in Southwest Uganda. AIDS Res Hum Retroviruses. 2000; 16 (5): 393-401.

(47.) Roman F, Karita E, Monnet A, Lambert C, Fontaine E, Allen S, Schneider F, Hemmer R, Schmit JC, Arendt V. Rare and new V3 loop variants in HIV-1 positive long-term non progressors from Rwanda . AIDS. 2002; 16: 1827-9.

(48.) Koch N, Ndihokubwayo JB, Yahi N, Tourres C, Fantini J, Tamalet C. Genetic Analysis of HIV Type 1 Strains in Bujumbura (Burundi): Predominance of Subtype C Variant. AIDS Res Hum Retroviruses. 2001; 17 (3): 269-73.

(49.) Vidal N, Niyongabo T, Nduwimana J, Butel C, Ndayiragije A, Wakana J, Nduwimana M, Delaporte E, Peeters M. HIV Type 1 Diversity and Antiretroviral Drug Resistance Mutations in Burundi. AIDS Res Hum Retroviruses. 2007; 23 (1): 175-80.

(50.) Mosha F, Urassa W, Aboud S, Lyamuya E, Sandstrom E, Bredell H, Williamson C. Prealence of Genotypic Resistance to Antiretroviral Drugs in Treatment-Naive Youths Infected with Diverse HIV Type 1 Subtypes and Recombinant Forms in Dar es Salaam, Tanzania. AIDS Res Hum Retroviruses. 2011; 27 (4): 377-382.

(51.) Nyombi BM, Kristiansen KI, Bjune G, Muller F, Holm-Hansen. Diversity of Human Immunodeficiency Virus Type 1 Subtypes in Kagera and Kilimanjaro Regions, Tanzania. AIDS Res Hum Retroviruses. 2008; 24 (6): 761-69.

(52.) Morison L, Buve A, Zekeng L, Heyndrickx L, Anagonou S, Musonda R, Kahindo M, Weiss HA, Hayes RJ, Laga M, Janssens W, van der Groen G; Study Group on Heterogeneity of HIV Epidemics in African Cities.. HIV-1 subtypes and the HIV epidemics in four cities in sub- Saharan Africa.. AIDS. 2001; 15 (suppl 4): S109-16.

(53.) Yang C, Li M, Shi YP, Winter J, Van Eijk AM, Ayisi J, Hu DJ, Steketee R Nahlen B, Lal RB. Genetic Diversity and High Proportion of Intersubtype Recombinants among HIV Type 1 Infected Pregnant Women in Kisumu, Western Kenya. AIDS Res Hum Retroviruses. 2004; 20 (5): 565-74.

(54.) Khoja S, Ojwang P, Khan S, Okinda N, Harania R, Ali S. Genetic Analysis of HIV-1 Subtypes in Nairobi, Kenya. PLoS ONE. 2008; 3 (9): e3191.

(55.) Abecasis A, Paraskevis D, Epalanga M, Fonseca M, Burity F, Bartolomeu J, Carvalho AP, Gomes P, Vandamme AM, Camacho R. HIV-1 Genetic Variants Circulation in the North of Angola. Infection, Genetics and Evolution. 2005; 5: 231-37.

(56.) Bartolo I, Epalanga M, Bartolemeu J, Fonseca M, Mendes A, Gama A, Taveira N. High Genetic Diversity of Human Immunodeficiency Virus Type 1 in Angola. AIDS Res Hum Retroviruses. 2005; 21 (4): 306-10.

(57.) Bartolo I, Rocha C, Bartolomeu J, Gama A, Fonseca M, Mendes A, Cristina F, Thamm S, Epalanga M, Silva PPC, Taveira N. Antiretroviral Drug Resistance Surveillance among Treatment-Naive Human Immunodeficiency Virus Type 1-Infected individuals in Angola: evidence for Low Level of Transmitted Drug Resistance. Antimicrob Agents and Chemother. 2009; 53 (7): 3156-58.

(58.) Taniguchi Y et al. Genetic Subtypes of HIV Type 1 Based on the vpu/env Sequences in the Republic of Congo. AIDS Res Hum Retroviruses. 2002; 18 (1): 79-83.

(59.) Candotti D, Tareau C, Barin F, Joberty C, Rosenheim M, M'pele P, Huraux JM, Agut H. Genetic Subtyping and V3 Serotyping of Type 1 Isolates in Congo. AIDS Res Hum Retroviruses. 1999; 15 (3): 309-14.

(60.) Mbondjeka I et al. Genetic Diversity of HIV-1 group M from Camerron and Republic of Congo. Arch Virol. 1999; 144: 2291-311.

(61.) McCutchan FE. Understanding the genetic diversity of HIV-1. AIDS. 2000; 14 Suppl 3: S31-44.

(62.) Anderson JP et al. Testing the hypothesis of a recombinant origin of human immunodeficiency virus type 1 subtype E. J. Virol .2000; 74: 10752-65.

(63.) Takehisa J, Zekeng L, Ido E, Mboudjeka I, Moriyama H, Miura T, Yamashita M, Gurtler LG, Hayami M, Kaptue L. Various Types of HIV Mixed Infections in Cameroon. Virology. 1998; 245: 1-10.

(64.) Carr JK et al. The AG Recombinant IbNG and Novel Strains of Group M HIV-1 are Common in Cameroon. Virology. 2001; 286: 168-81.

(65.) Bouzeghoub S, Belabbes EH. La Diversite genetique du VIH-1 et donnees actuelles en Algerie. Revue Francophone des Laboratoires. 2007; 396: 25-8.

(66.) DerSimonian R, Laird N. Meta-analysis in clinical trials. Con Clin Trials. 1986; 7: 177-88

(67.) D'Agostino RB, Weintraub S. Meta-analysis: a method for synthesizing research. Clin Pharm Therapeutics. 1995; 58: 605-16.

(68.) Bland CJ, Meurer LN, Maldonado G. A systematic approach to conducting a non-statistical metaanalysis of research literature. Academic Medicine. 1995; 70: 642-53.

Kamangu Ntambwe Erick [1 *], Kabututu Zakayi [1], Mvumbi Lelo Georges [1], Kalala Lunganza Richard [1], Mesia Kahunu Gauthier [2]

[1] Department of Basic Sciences, Faculty of Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo (DRC)

[2] Department of Pharmacology, Faculties of Medicine and Pharmaceutical Sciences, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo (DRC)

* Corresponding Author: KAMANGU NTAMBWE Erick

Email: erick.kamangu@unikin.ac.cd
Table 1 : Variants circulating in the Eastern portion (Bukavu,
Kisangani, Lubumbashi, Likasi)

Types/Sous-types/CRFs         Kisangani

                   2002       2006 [31]         Means
                [DELTA] [6]    (n=83)       Kisangani (%)
                  (n=23)

M   A           8 (34,75%)    39 (47,0%)  40,875 [34,7547,0]
    B                0        4 (4,8%)       2,4 [0-4,8]
    C            1 (4,35%)    1 (1,2%)     2,78 [1,2-4,35]
    D            4 (17,4%)    6 (7,2%)     12,3 [7,2-17,4]
    F            1 (4,35%)    3 (3,6%)     3,98 [3,6-4,35]
    G            5 (21,7%)    18 (21,7%)         21,7
    H            3 (13,0%)        0          6,5 [0-13,0]
    J                0        2 (2,4%)       1,2 [0-2,4]
    K                0            0               0
    CRF01-AE         0            0               0
    CRF02-AG         0            0               0
    CRF05-DF         0            0               0
    CRF11-cpx        0            0               0
    U            1 (4,35%)    10 (12,0%)   8,18 [4,3512,0]

Types/Sous-        Lubumbash        Likasi
types/CRFs            i

                     2002            2004
                  [DELTA] [6]   [omicron] [30]
                    (n=144)     (n=27, n'=11)

M   A             57 (39,6%)      5 (45,45%)
    B                   0              0
    C               14 (9,7%)      2 (18,2%)
    D              20 (13,9%)       1 (9,1%)
    F               2 (1,4%)           0
    G              15 (10,4%)       1 (9,1%)
    H               9 (6,25%)          0
    J               2 (1,4%)       2 (18,2%)
    K               4 (2,8%)           0
    CRF01-AE        4 (2,8%)           0
    CRF02-AG        3 (2,1%)        1 (9,1%)
    CRF05-DF        2 (1,4%)           0
    CRF11-cpx       1 (0,7%)           0
    U               11 (7,6%)          0

Types/Sous-         Bukavu      Means % DRC-East
types/CRFs

                     2007
                  [31] (n=83)

M   A             44 (53,0%)    44,73 [39,6-53,0]
    B               1 (1,2%)        0,9 [0-4,8]
    C              15 (18,1%)    12,20 [1,2-18,2]
    D               1 (1,2%)      9,12 [1,2-17,4]
    F               4 (4,8%)       2,54 [0-4,8]
    G               4 (4,8%)      11,5 [4,8-21,7]
    H               1 (1,2%)       3,49 [0-13,0]
    J                   0          5,2 [0-18,2]
    K                   0           0,7 [0-2,8]
    CRF01-AE            0           0,7 [0-2,8]
    CRF02-AG            0           2,8 [0-9,1]
    CRF05-DF            0          0,35 [0-1,4]
    CRF11-cpx           0          0,175 [0-0,7]
    U              11 (13,2%)      7,24 [0-13,2]

([DELTA]) Identification by sequencing the genome part env

No identification by sequencing of env and pol part of the genome

* ID by sequencing part of the gag and env genome

(+) Identification by sequencing the pol part of the genome

n 'match phylogenetic

Different averages are expressed in "% Average [% extremes]"

Table 2: Variants circulating in the Central share (Bwamanda
Mbuji Mayi)

                       Bwamanda

Types/Sous-types         1997          1997
                      [DELTA] [4]   [DELTA] [4]
                        (n=45)        (n=60)

M   A               3 31 (68,9%)    34 (56,7%)
    B                  1 (2,2%)          0
    C                      0        15 (25,0%)
    D                      0         4 (6,6%)
    E                  3 (6,7%)          0
    F                  1 (2,2%)      1 (1,7%)
    G                      0         2 (3,3%)
    H                  4 (8,9%)          0
    J                      0         2 (3,3%)
    K                  2 (4,4%)      1 (1,7%)
    CRF01-AE              --            --
    CRF02-AG              --            --
    CRF05-DF              --            --
    CRF11-cpx             --            --
    CRF13-cpx             --            --
    CRF26-A5U           --            --
    U                3 (6,6%)      1 (1,7%)

                        Mbuji Mayi

                           2002
Types/Sous-types       [DELTA] [6]     Means Mbuji
                          (n=43)         Mayi (%)

M   A                   24 (55,8%)    56,25 [55.8-56.7]
    B                        0              0
    C                    7 (16,3%)    20,65 [16.3-25.0]
    D                    4 (9,3%)       7,95 [6.6-9.3]
    E                        0              0
    F                        0        0,85 [0-1.7]
    G                    1 (2,3%)        2,8 [2.3-3.3]
    H                    1 (2,3%)        1,15 [0-2.3]
    J                    3 (7,0%)       5,15 [3.3-7.0]
    K                        0        0,85 [0-1.7]
    CRF01-AE                 0              0
    CRF02-AG             2 (4,65%)        2,33 [0-4.65]
    CRF05-DF                 0              0
    CRF11-cpx                0              0
    CRF13-cpx                0              0
    CRF26-A5U             --              0
    U                  1 (2,33%)       2,01 [1.7-2.33]

Types/Sous-types       Means % DRC-Central

M   A                    62,57 [55.8-68.9]
    B                       1,1 [0-2,2]
    C                     10,32 [0-25.0]
    D                      3,97 [0-9.3]
    E                      3,35 [0-6.7]
    F                      1,53 [0-2.2]
    G                       1,4 [0-3.3]
    H                      5,02 [0-8.9]
    J                      2,58 [0-7.0]
    K                      2,63 [0-4.4]
    CRF01-AE                     0
    CRF02-AG               1,16 [0-4.65]
    CRF05-DF                     0
    CRF11-cpx                    0
    CRF13-cpx                    0
    CRF26-A5U                    0
    U                      4,3 [1.7-6.6]

([DELTA]) Identification by sequencing the genome part env

No identification by sequencing of env and pol part of the genome

* ID by sequencing part of the gag and env genome

(+) Identification by sequencing the pol part of the genome

Different averages are expressed in "% Average [% extremes]"

Table 3: Variants circulating in the Western part (Kinshasa, Kimpese)

                           Kinshasa

Types/Sous-type     1985-86 * [7]      1997
CRFS                (n=24, n'=16)    [DELTA] [4]
                                      (n=142)

M   A                5 (31,2%)      62 (43,7%)
    B                    0               0
    C                    0           3 (2,2%)
    D                 1 (6,2%)      19 (13,4%)
    E                    0           1 (0,7%)
    F                2 (12,5%)       8 (5,6%)
    G                6 (37,5%)      15 (10,5%)
    H                    0           14 (9,8%)
    J                    0           5 (3,5%)
    K                    0           4 (2,8%)
    CRF01-AE         2 (12,5%)           0
    CRF02-AG             0               0
    CRF05-DF             0               0
    CRF11-cpx            0               0
    U                    0           11 (7,7%)

                        Kinshasa

Types/Sous-type                         2002
CRFS              1999-2000 * [7]    [DELTA] [6]
                   (n=83, n'=44)       (n=144)

M   A                15 (34,1%)       57 (39,6%)
    B                    0                0
    C                5 (11,4%)         14 (9,7%)
    D                8 (18,2%)        20 (13,9%)
    E                    0                0
    F                 2 (4,5%)         2 (1,4%)
    G                10 (22,7%)       15 (10,4%)
    H                 1 (2,3%)         9 (6,25%)
    J                 1 (2,3%)         2 (1,4%)
    K                    0             4 (2,8%)
    CRF01-AE          2 (4,5%)         4 (2,8%)
    CRF02-AG             0             3 (2,1%)
    CRF05-DF             0             2 (1,4%)
    CRF11-cpx            0             1 (0,7%)
    U                    0            11 (7,6%)

                              Kinshasa

Types/Sous-type      2007+ [10]             Means
CRFS                  (n=94)            Kinshasa (%)

M   A                22 (23,0%)        34,32 [23.043.7]
    B                    0                   0
    C                13 (13,8%)         7,42 [2.213.8]
    D                 4 (4,3%)          11,2 [4.318.2]
    E                    0              0,14 [0-0.7]
    F                     0              4,8 [0-12.5]
    G                 5 (5,3%)         17,28 [5.337.5]
    H                 1 (1,1%)           3,89 [0-9.8]
    J                 1 (1,1%)           1,66 [0-3.5]
    K                     0              1,12 [0-2.8]
    CRF01-AE      ([double dagger])     4,95 [0-12.5]
    CRF02-AG      ([double dagger])      0,52 [0-2.1]
    CRF05-DF      ([double dagger])      0,35 [0-1.4]
    CRF11-cpx     ([double dagger])      0,17 [0-0.7]
    U                2 (2,1%)           3,48 [0-7.7]

                        Kimpese

Types/Sous-type     1988-94 (g) [5]        Means %
CRFS                   (n=70)            DRC-West

M   A                 29 (47,5%)      40,91 [23.0-47.5]
    B                      0                   0
    C                   1 (1,6%)        4,51 [1.6-13.8]
    D                   6 (9,8%)        10,5 [4.3-18.2]
    E                   2 (3,2%)         1,67 [0-3.2]
    F                   4 (6,5%)         5,65 [0-12.5]
    G                  13 (21,3%)      19,29 [5.3-37.5]
    H                   3 (4,9%)          4,4 [0-9.8]
    J                      0             0,83 [0-3.5]
    K                      0             0,56 [0-2.8]
    CRF01-AE               0             2,47 [0-12.5]
    CRF02-AG               0             0,26 [0-2.1]
    CRF05-DF               0             0,17 [0-1.4]
    CRF11-cpx              0             0,08 [0-0.7]
    U                      0             1,74 [0-7.7]

([DELTA]) Identification by sequencing the genome part env

No identification by sequencing of env and pol part of the genome

* ID by sequencing part of the gag and env genome

(+) Identification by sequencing the pol part of the genome

(g) Identification by sequencing the portion of the genome gag
n 'match phylogenetic

([double dagger]) 15% CRFs (01_AE, 02_AG, 11_cpx, 13_cpx, 25_cpx,
26_A5U, 37_cpx, 43_02G and 45_cpx) Different averages are
expressed in "% Average [% extremes]"_

Table 4 : Variants circulating in The Democratic Republic of
Congo

                     RDC

Types/Sous-      N=247 [8] en %      Means DRC-
types/CRFs                           East en %

M   A                51,4        44,73 [39,6-53,0]
    B                0,4            0,9 [0-4,8]
    C                7,3         12,20 [1,2-18,2]
    D                9,3          9,12 [1,2-17,4]
    E                 0                  0
    F                4,1           2,54 [0-4,8]
    G                6,9          11,5 [4,8-21,7]
    H                7,3           3,49 [0-13,0]
    J                2,8           5,2 [0-18,2]
    K                3,2            0,7 [0-2,8]
    CRF01-AE         1,6            0,7 [0-2,8]
    CRF02-AG         2,55           2,8 [0-9,1]
    CRF05-DF          --           0,35 [0-1,4]
    CRF11-cpx         --           0,175 [0-0,7]
    CRF13-cpx         --                 0
    CRF26-A5U         0                  0
    U                6,0           7,24 [0-13,2]

Types/Sous-          Means DRC-         Means DRC-West
types/CRFs          Central en %             en %

M   A              62,57 [55,8-68,9]   40,91 [23,0-47,5]
    B                 1,1 [0-2,2]              0
    C               10,32 [0-25,0]      4,51 [1,6-13,8]
    D                3,97 [0-9,3]       10,5 [4,3-18,2]
    E                3,35 [0-6,7]        1,67 [0-3,2]
    F                1,53 [0-2,2]        5,65 [0-12,5]
    G                 1,4 [0-3,3]      19,29 [5,3-37,5]
    H                5,02 [0-8,9]         4,4 [0-9,8]
    J                2,58 [0-7,0]        0,83 [0-3,5]
    K                2,63 [0-4,4]        0,56 [0-2,8]
    CRF01-AE               0             2,47 [0-12,5]
    CRF02-AG         1,16 [0-4,65]       0,26 [0-2,1]
    CRF05-DF               0             0,17 [0-1,4]
    CRF11-cpx              0             0,08 [0-0,7]
    CRF13-cpx              0                   0
    CRF26-A5U              0                   0
    U                4,3 [1,7-6,6]       1,74 [0-7,7]

Types/Sous-          Means DRC * en %
types/CRFs

M   A                49,40 [23,0-68,9]
    B                  0,67 [0-4,8]
    C                  9,01 [0-18,2]
    D                  7,86 [0-18,2]
    E                  1,67 [0-6,7]
    F                  3,24 [0-12,5]
    G                 10,73 [0-37,5]
    H                  4,30 [0-13,0]
    J                  2,87 [0-18,2]
    K                  1,30 [0-4,4]
    CRF01-AE           1,06 [0-12,5]
    CRF02-AG           1,41 [0-9,1]
    CRF05-DF           0,17 [0-1,4]
    CRF11-cpx          0,085 [0-0,7]
    CRF13-cpx                0
    CRF26-A5U                0
    U                  4,43 [0-13,2]

* According to literature review
COPYRIGHT 2013 DRUNPP
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2013 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Erick, Kamangu Ntambwe; Zakayi, Kabututu; Georges, Mvumbi Lelo; Richard, Kalala Lunganza; Gauthier,
Publication:International Journal of Collaborative Research on Internal Medicine & Public Health (IJCRIMPH)
Article Type:Report
Geographic Code:6ZAIR
Date:May 1, 2013
Words:5902
Previous Article:Utilization of radiology service at Dungun District Hospital in Malaysia.
Next Article:Bio-electrical impedance analysis versus anthropometry as predictor for hypertension.
Topics:

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters