title: The Evolving HIV-1 Epidemic in Warao Amerindians Is Dominated by an Extremely High Frequency of CXCR4-Utilizing Strains.
abstract: We previously reported a high prevalence of HIV-1 infection in Warao Amerindians from Venezuela due to the rapid spread of a single B subtype strain. In this study we evaluated the coreceptor use of the HIV-1 strains infecting this Amerindian community. Sequences of the HIV-1 V3 loop from 56 plasma samples were genotyped for coreceptor use. An extremely high frequency of CXCR4 strains was found among HIV-1-infecting Waraos (47/49, 96%), compared to HIV-1 strains infecting the non-Amerindian Venezuelan population (35/79, 44%, p < 0.00001). Evolutionary analysis showed that a significant number of infections occurred between 1 and 12 months before collection and that a great proportion (50-70%) of HIV-1 transmissions occurred within the very early phase of infection (≤12 months). This is consistent with an initial infection dominated by an X4 strain or a very rapid selection of X4 variants after infection. This Amerindian population also exhibits the highest prevalence of tuberculosis in Venezuela, being synergistically bad prognostic factors for the evolution of morbidity and mortality in this vulnerable population.
authors.affiliation: 1 Laboratorio de Virología Molecular, Instituto Venezolano de Investigaciones Científicas , Caracas, Venezuela .
authors.forename: Héctor R
authors.initials: HR
authors.lastname: Rangel
authors.affiliation: 2 Laboratorio de AIDS e Inmunología Molecular Instituto Oswaldo Cruz , FIOCRUZ, Rio de Janeiro, Brazil .
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Bello
authors.affiliation: 3 Laboratorio de Tuberculosis, Instituto de Biomedicina , Caracas, Venezuela .|4 Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, Massachusetts.
authors.forename: Julian A
authors.initials: JA
authors.lastname: Villalba
authors.affiliation: 1 Laboratorio de Virología Molecular, Instituto Venezolano de Investigaciones Científicas , Caracas, Venezuela .
authors.forename: Yoneira F
authors.initials: YF
authors.lastname: Sulbaran
authors.affiliation: 1 Laboratorio de Virología Molecular, Instituto Venezolano de Investigaciones Científicas , Caracas, Venezuela .
authors.forename: Domingo
authors.initials: D
authors.lastname: Garzaro
authors.affiliation: 3 Laboratorio de Tuberculosis, Instituto de Biomedicina , Caracas, Venezuela .|5 Department of Medicine, University of Cambridge , Cambridge, United Kingdom .
authors.forename: Mailis
authors.initials: M
authors.lastname: Maes
authors.affiliation: 1 Laboratorio de Virología Molecular, Instituto Venezolano de Investigaciones Científicas , Caracas, Venezuela .
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Loureiro
authors.affiliation: 3 Laboratorio de Tuberculosis, Instituto de Biomedicina , Caracas, Venezuela .
authors.forename: Jacobus H
authors.initials: JH
authors.lastname: de Waard
authors.affiliation: 1 Laboratorio de Virología Molecular, Instituto Venezolano de Investigaciones Científicas , Caracas, Venezuela .
authors.forename: Flor H
authors.initials: FH
authors.lastname: Pujol
mesh_terms: D058872:Epidemics; D005260:Female; D005838:Genotype; D015699:HIV Envelope Protein gp120 / Q000235:genetics; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D007197:Indians, Central American; D008297:Male; D010949:Plasma / Q000821:virology; D019718:Receptors, CXCR4 / Q000378:metabolism*; D015728:Receptors, HIV / Q000378:metabolism*; D017422:Sequence Analysis, DNA; D014687:Venezuela / Q000453:epidemiology
chemical_list: C527276:CXCR4 protein, human; D015699:HIV Envelope Protein gp120; D019718:Receptors, CXCR4; D015728:Receptors, HIV; C514793:gp120 protein, Human immunodeficiency virus 1