title: A novel multiregion hybridization assay reveals high frequency of dual inter-subtype infections among HIV-positive individuals in Cameroon, West Central Africa.
abstract: In West and West Central Africa, multiple subtypes, circulating recombinant forms (CRF), and high proportions of unique recombinant forms (URF) are documented. The predominance of recombinants strongly suggests that dual infections occur frequently. In the present study, we adapted the multi-region hybridization assay (MHA), previously developed to identify dual infections in geographic regions where few HIV-1 variants circulate, to identify HIV-1 variants and dual infections. We designed clade-specific probes in three genomic regions (gag p17, vpu, nef) to detect eight different variants that are common in this part of Africa (A, B/D, C, F, G, CRF02_AG, CRF06_cpx, CRF22_01A1). The assay was validated with 163 samples representing the corresponding HIV-1 variants. Depending on the genomic regions, the global sensitivity of the assay ranged from 86% to 94%, and the global specificity was between 85% and 96%. The assay was then applied on 156 antiretroviral treatment-naive patients from Cameroon. The MHA assay identified 79%, 85% and 90% of the strains in nef, gag and vpu regions, respectively. The subtype/CRF distribution and the proportion of inter-region recombinants obtained by the new MHA assay were in accordance with known subtype/CRF distribution in Cameroon. Moreover, the MHA assay identified 35 (22.4%) patients as dually infected, from which 20 were reactive in more than one region and/or with concordant multigenomic recombination pattern. Despite the high genetic diversity, we successfully developed an hybridization assay allowing identification of eight common HIV-1 variants circulating in West and West Central Africa. We documented high rates of dual infection in a low-risk population group, illustrating that the global evolution of HIV diversity is driven by dual infections. This assay could become a useful screening tool for the global surveillance and monitoring of inter-subtype/CRF dual infections in West and West Central Africa.
authors.affiliation: UMI 233, Institut de Recherches pour le Développement (IRD) et Université de Montpellier I, Montpellier, France. nicole.vidal@ird.fr
authors.forename: Nicole
authors.initials: N
authors.lastname: Vidal
authors.forename: Halimatou
authors.initials: H
authors.lastname: Diop
authors.forename: Céline
authors.initials: C
authors.lastname: Montavon
authors.forename: Christelle
authors.initials: C
authors.lastname: Butel
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Bosch
authors.forename: Eitel Mpoudi
authors.initials: EM
authors.lastname: Ngole
authors.forename: Coumba
authors.initials: C
authors.lastname: Touré-Kane
authors.forename: Souleymane
authors.initials: S
authors.lastname: Mboup
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
authors.forename: Martine
authors.initials: M
authors.lastname: Peeters
mesh_terms: D002163:Cameroon / Q000453:epidemiology; D016679:Genome, Viral; D005838:Genotype; D015488:HIV Antigens / Q000235:genetics; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000145:classification* / Q000235:genetics*; D054298:Human Immunodeficiency Virus Proteins / Q000235:genetics; D006801:Humans; D008969:Molecular Sequence Data; D009693:Nucleic Acid Hybridization / Q000379:methods; D010802:Phylogeny; D011995:Recombination, Genetic; D012680:Sensitivity and Specificity; D054334:Viral Regulatory and Accessory Proteins / Q000235:genetics; D054301:gag Gene Products, Human Immunodeficiency Virus / Q000235:genetics; D054311:nef Gene Products, Human Immunodeficiency Virus / Q000235:genetics; D000086082:Viroporin Proteins
chemical_list: D015488:HIV Antigens; D054298:Human Immunodeficiency Virus Proteins; D054334:Viral Regulatory and Accessory Proteins; D054301:gag Gene Products, Human Immunodeficiency Virus; D054311:nef Gene Products, Human Immunodeficiency Virus; C514837:nef protein, Human immunodeficiency virus 1; C054858:p17 protein, Human Immunodeficiency Virus Type 1; C514859:vpu protein, Human immunodeficiency virus 1; D000086082:Viroporin Proteins