title: [The first detected HIV-1 recombinant strain in Turkey: CRF08_BC].
abstract: A major proportion of the HIV infections worldwide is caused by group M of HIV-1 genotype and to date approximately nine subtypes and 50 circulating recombinant forms (CRFs) in the group M have been recognized. Recombinants between different HIV-1 group M subtypes are designated as CRF. The objective of this study was to present, for the first time, a HIV-1 positive case infected with CRF08_BC subtype in Turkey. In beginning of 2011, a sailor, 48-year-old male was admitted to hospital with fever, loss of appetite, weight loss, 15 days lasting diarrhea and bilateral axillary lymphadenitis. The laboratory tests yielded anti-HIV positivity, HIV-RNA positivity (129.000 copies/ml) and CD4+ T-cell count of 11 cells/mm3 (1.3%). He had a history of multiple unprotected sexual contacts during his journey to various far-east countries. His clinical level was defined as C3 according to CDC classification. Since drug resistance analysis done before the initiation of antiretroviral therapy indicated no antiretroviral resistance, tenofovir/emtricitabin + efavirenz therapy was initiated. In the 16th months of the therapy, decreasing CD4+ T-cell count, HIV-RNA positivity and worsening of clinical condition (development of herpes lesions and pulmonary tuberculosis) suggested an unresponsiveness to therapy, efavirenz was replaced with tenofovir/emtricitabin + lopinavir/ritonavir. The patient was also treated with quadruple anti-tuberculous treatment based on the clinical and radiological findings of pulmonary tuberculosis. The protease domain (codon 1-99, 330 bp) of pol gene of HIV-1 strain obtained from pretreatment plasma sample, had been amplified by nested PCR and sequenced. This HIV-1 strain was then subtyped as CRF08_BC after phylogenetic analysis with neighbor-joining method (GenBank accession number: JX536763.1). In the world, HIV-1 CRF08_BC is substantially prevalent in southwestern China among injecting drug users. Our data suggested that the CRF08_BC subtype is also present in Turkey. Molecular epidemiologic studies are important tools for tracking transmission patterns, spread and for the control of the HIV infections in a given area. Therefore, HIV molecular research should be expanded in HIV-1 infected Turkish patients. The determination of subtype CRF08_BC of HIV-1 in Turkey may be contribute to global HIV surveillance systems.
authors.affiliation: Kocaeli University Medical Faculty Hospital, Kocaeli, Turkey. sayanmurat@hotmail.com
authors.forename: Murat
authors.initials: M
authors.lastname: Sayan
authors.forename: Selçuk
authors.initials: S
authors.lastname: Kaya
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000821:virology*; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D012367:RNA, Viral / Q000032:analysis; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy; D014421:Turkey
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents; D012367:RNA, Viral