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27 HIV-1 Group M Subtypes in Rural Villages in Cameroon
P. Nyambi*1, L. Zekeng2, S. Burda1, M. Urbanski1, H. Kenfack2, M. Tongo2, N. Aubin2, J. Shang2, P. Zhong1, and H. Mbah1
1New York Univ. Sch. of Med., New York, USA and 2Lab. de la Sante Hygiene Mobile, Yaounde, Cameroon
Background: The HIV-1 epidemic in Cameroon is characterized by extensive genetic variability with representatives of groups M, N, and O. Studies now reveal the presence of CRF02_AG and subtype A, constituting 90% of the total group M infections in major cities, whereas only 10% of infections are with other subtypes. There is, however, little information available on the group M subtype distribution in rural villages in Cameroon.
Methods: HIV-1 group M subtype infections in persons living in villages of Cameroon were analyzed using plasma samples collected between April 2000 and October 2000. RNA was extracted and processed by reverse transcriptase-polymerase chain reaction (RT-PCR) for amplification of parts of gag and env. Subtyping was performed by gag and env heteroduplex mobility assay (HMA) or by sequencing and phylogenetic analysis of the C2V3 of env and a portion of p24 gag.
Results: Of the 37 samples analyzed, both gag and env subtypes could be determined on 19 samples. Of these 19 samples, 11 (58%) were subtyped as CRF02_AG/A (n = 9), CRF01_AE/A (n = 1), and A/A (n = 1), and 8 (42%) were subtyped as G/G (n = 2), H/H (n = 2), D/D (n = 3), and D/H (n = 1) in both gag/env. Nine of the 37 samples could only be classified using gag and were identified as CRF02_AG (n = 8) and CRF01_AE (n = 1). Eighteen of the 37 samples could not be classified into existing group M subtypes.
Conclusions: Our findings show that in rural villages in Cameroon, 42% of infections are non-CRF02_AG and non-A subtypes in gag/env. Therefore, in Cameroon, the diversity of group M HIV-1-causing infections in rural villages appears to be broader than that observed in major cities. These results illuminate the evolution of the epidemic in an area of tremendous HIV diversity and have implications for diagnosis, transmission, and prevention of HIV in rural areas of Africa.
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