title: Genetic Diversity of HIV-1 in Tunisia.
abstract: In this study, the genetic diversity of HIV-1 in Tunisia was analyzed. For this, 193 samples were collected in different regions of Tunisia between 2012 and 2015. A protease and reverse transcriptase fragment were amplified and sequenced. Phylogenetic analyses were performed through maximum likelihood and recombination was analyzed by bootscanning. Six HIV-1 subtypes (B, A1, G, D, C, and F2), 5 circulating recombinant forms (CRF02_AG, CRF25_cpx, CRF43_02G, CRF06_cpx, and CRF19_cpx), and 11 unique recombinant forms were identified. Subtype B (46.4%) and CRF02_AG (39.4%) were the predominant genetic forms. A group of 44 CRF02_AG sequences formed a distinct Tunisian cluster, which also included four viruses from western Europe. Nine viruses were closely related to isolates collected in other African or in European countries. In conclusion, a high HIV-1 genetic diversity is observed in Tunisia and the local spread of CRF02_AG is first documented in this country.
authors.affiliation: 1 Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital , Tunis, Tunisia .|2 Laboratory of Research "resistance to antibiotics," Faculty of Medicine of Tunis , Tunis, Tunisia .|3 The Global Fund to Fight AIDS , Tuberculosis and Malaria, Geneva, Switzerland .
authors.forename: Awatef
authors.initials: A
authors.lastname: El Moussi
authors.affiliation: 4 HIV Biology and Variability Unit, Centro Nacional de Microbiología , Instituto de Salud Carlos III, Madrid, Spain .
authors.forename: Michael M
authors.initials: MM
authors.lastname: Thomson
authors.affiliation: 4 HIV Biology and Variability Unit, Centro Nacional de Microbiología , Instituto de Salud Carlos III, Madrid, Spain .
authors.forename: Elena
authors.initials: E
authors.lastname: Delgado
authors.affiliation: 4 HIV Biology and Variability Unit, Centro Nacional de Microbiología , Instituto de Salud Carlos III, Madrid, Spain .
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Cuevas
authors.affiliation: 1 Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital , Tunis, Tunisia .
authors.forename: Majda
authors.initials: M
authors.lastname: Nasr
authors.affiliation: 1 Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital , Tunis, Tunisia .|2 Laboratory of Research "resistance to antibiotics," Faculty of Medicine of Tunis , Tunis, Tunisia .
authors.forename: Salma
authors.initials: S
authors.lastname: Abid
authors.affiliation: 1 Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital , Tunis, Tunisia .|2 Laboratory of Research "resistance to antibiotics," Faculty of Medicine of Tunis , Tunis, Tunisia .
authors.forename: Mohamed Ali
authors.initials: MA
authors.lastname: Ben Hadj Kacem
authors.affiliation: 5 Infectious Diseases Department, Rabta University Hospital , Tunis, Tunisia .
authors.forename: Hanene
authors.initials: H
authors.lastname: Benaissa Tiouiri
authors.affiliation: 6 Infectious Diseases Department, Farhat Hached University Hospital , Sousse, Tunisia .
authors.forename: Amel
authors.initials: A
authors.lastname: Letaief
authors.affiliation: 7 Infectious Diseases Department, Fatouma Bourguiba University Hospital , Monastir, Tunisia .
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chakroun
authors.affiliation: 8 Infectious Diseases Department, Hedi Chaker University Hospital of Sfax , Sfax, Tunisia .
authors.forename: Mounir
authors.initials: M
authors.lastname: Ben Jemaa
authors.affiliation: 3 The Global Fund to Fight AIDS , Tuberculosis and Malaria, Geneva, Switzerland .|9 Primary Health Care Directory (DSSB) , Ministry of Health, Tunis, Tunisia .
authors.forename: Hayet
authors.initials: H
authors.lastname: Hamdouni
authors.affiliation: 9 Primary Health Care Directory (DSSB) , Ministry of Health, Tunis, Tunisia .
authors.forename: Rafla
authors.initials: R
authors.lastname: Tej Dellagi
authors.affiliation: 3 The Global Fund to Fight AIDS , Tuberculosis and Malaria, Geneva, Switzerland .|10 National Office of Family and Population , Tunis, Tunisia .
authors.forename: Khaled
authors.initials: K
authors.lastname: Kheireddine
authors.affiliation: 1 Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital , Tunis, Tunisia .|2 Laboratory of Research "resistance to antibiotics," Faculty of Medicine of Tunis , Tunis, Tunisia .
authors.forename: Ilhem
authors.initials: I
authors.lastname: Boutiba
authors.affiliation: 4 HIV Biology and Variability Unit, Centro Nacional de Microbiología , Instituto de Salud Carlos III, Madrid, Spain .
authors.forename: Lucía
authors.initials: L
authors.lastname: Pérez-Álvarez
authors.affiliation: 1 Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital , Tunis, Tunisia .|2 Laboratory of Research "resistance to antibiotics," Faculty of Medicine of Tunis , Tunis, Tunisia .
authors.forename: Amine
authors.initials: A
authors.lastname: Slim
mesh_terms: D016000:Cluster Analysis; D005060:Europe; D014644:Genetic Variation; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology*; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D017720:Molecular Epidemiology; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D011995:Recombination, Genetic; D017422:Sequence Analysis, DNA; D014416:Tunisia / Q000453:epidemiology
chemical_list: C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase; D016333:HIV Protease; C514803:p16 protease, Human immunodeficiency virus 1
keywords: HIV-1; Tunisia; genetic diversity; recombinant forms; unique recombinant forms