Low Estimates of HIV Seroconversions Among Clients of a Drug Treatment Clinic in San Francisco, 1995 to 1998

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Abstract
Summary:Limited data exist on the distribution of HIV-1 subtypes in Côte d'Ivoire. The aim of this study is to describe the distribution of genetic subtypes of HIV-1 strains in six regions of Côte d'Ivoire. In 1997, we consecutively collected blood from 172 HIV-1-infected patients from six regional tuberculosis treatment centers. Peripheral blood mononuclear cells (PBMCs) from these people were analyzed by a restriction fragment-length polymorphism (RFLP) assay that involves a sequential endonuclease digestion of a 297-base pair polymerase chain reaction (PCR) fragment; plasma samples were tested by a V3-loop peptide enzyme immunoassay (PEIA). DNA sequencing of the protease or env genes was performed on all samples discordant in the two assays as well as a random sample of the concordant subtyped samples. Of 172 specimens, 3 were PCR-negative, and 169 were putatively classified as subtype A by RFLP. The 3 PCR-negative samples were unequivocally subtyped A by PEIA. Of the 169 RFLP subtype A samples, 159 (94%) were subtyped A by PEIA. Of the 10 discordant samples, PEIA testing classified 3 as subtype C, 2 as D, and 5 as F. Sequencing of the env gene classified these samples as 1 subtype A, 4 Ds, and 5 Gs. Thus, 163 (95%) of the specimens were subtype A, 3 subtype D, 4 subtype G, 1 A/D, and 1 A/G (IbNG) circulating recombinant forms (CRF). In conclusion, most HIV-1- infected tuberculosis patients throughout the interior of Côte d'Ivoire are infected with HIV-1subtype A, which are very likely the A/G (IbNG) CRF. The uniform distribution of this subtype makes Côte d'Ivoire a potential site for vaccine trials. Address correspondence and reprint requests to John N. Nkengasong. Laboratory of Virology, Projet RETRO-CI, 01 BP 1712 Abidjan, Côte d'Ivoire; email:[email protected] Use of trade names is for identification only and does not imply endorsement by the U.S. Centers for Disease Control and Prevention nor the U.S. Department of Health and Human Services. Manuscript received June 9, 1999; accepted November 24, 1999. © 2000 Lippincott Williams & Wilkins, Inc.