title: HIV-1 subtype diversity in Minnesota.
abstract: BACKGROUND
  Genetic variation in human immunodeficiency virus (HIV)-1 poses significant public-health and clinical challenges. In North America, subtype B is most prevalent. HIV-1 subtyping is not integrated into routine HIV/acquired immunodeficiency syndrome surveillance in the United States. In 2003, the Minnesota Department of Health piloted HIV-1 subtyping with routine surveillance to describe the existence and variety of non-subtype B strains.
  
  
  METHODS
  Targeted HIV-1 subtype surveillance was conducted on 98 African-born HIV-infected patients. Sentinel subtype surveillance was conducted in a Minneapolis sexually transmitted disease clinic on 28 newly diagnosed non-African HIV-positive patients. Subtype determination was based on a partial sequence of the gp41 region of the HIV-1 env gene.
  
  
  RESULTS
  Subtyping was successful for 87 of 98 samples from African-born HIV-infected patients; 95% were non-B subtypes. The 7 subtypes observed were consistent with strains endemic in patients' birth regions. Subtyping was also completed for samples from 25 of 28 non-African-born patients; all were subtype B.
  
  
  CONCLUSIONS
  Multiple HIV-1 subtypes are present in Minnesota. Our data suggest that most of the HIV cases in Minnesota among African-born patients are non-B subtypes. Population-based surveillance inclusive of groups at high risk for variant strains is needed to monitor the prevalence and variety of HIV subtypes in the United States.
authors.affiliation: Minnesota Department of Health, Minneapolis, Minnesota 55414-9441, USA. t_sides@yahoo.com
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Sides
authors.forename: Omobosola
authors.initials: O
authors.lastname: Akinsete
authors.forename: Keith
authors.initials: K
authors.lastname: Henry
authors.forename: Jason T
authors.initials: JT
authors.lastname: Wotton
authors.forename: Peter W
authors.initials: PW
authors.lastname: Carr
authors.forename: Joanne
authors.initials: J
authors.lastname: Bartkus
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D005260:Female; D014644:Genetic Variation; D015700:HIV Envelope Protein gp41 / Q000235:genetics; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000235:genetics*; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D017720:Molecular Epidemiology; D010802:Phylogeny; D018571:Sentinel Surveillance
chemical_list: D015700:HIV Envelope Protein gp41