Subtype classification of Iranian HIV-1 sequences registered in the HIV databases, 2006-2013.

BACKGROUND: The rate of human immunodeficiency virus type 1 (HIV-1) infection in Iran has increased dramatically in the past few years. While the earliest cases were among hemophiliacs, injection drug users (IDUs) fuel the current epidemic. Previous molecular epidemiological analysis found that subtype A was most common among IDUs but more recent studies suggest CRF_35AD may be more prevalent now. To gain a better understanding of the molecular epidemiology of HIV-1 infection in Iran, we analyzed all Iranian HIV sequence data from the Los Alamos National Laboratory. METHODS: All Iranian HIV sequences from subtyping studies with pol, gag, env and full-length HIV-1 genome sequences registered in the HIV databases (www.hiv.lanl.gov) between 2006 and 2013 were downloaded. Phylogenetic trees of each region were constructed using Neighbor-Joining (NJ) and Maximum Parsimony methods. RESULTS: A total of 475 HIV sequences were analyzed. Overall, 78% of sequences were CRF_35AD. By gene region, CRF_35AD comprised 83% of HIV-1 pol, 62% of env, 78% of gag, and 90% of full-length genome sequences analyzed. There were 240 sequences re-categorized as CRF_AD. The proportion of CRF_35AD sequences categorized by the present study is nearly double the proportion of what had been reported. CONCLUSIONS: Phylogenetic analysis indicates HIV-1 subtype CRF_35AD is the predominant circulating strain in Iran. This result differed from previous studies that reported subtype A as most prevalent in HIV- infected patients but confirmed other studies which reported CRF_35AD as predominant among IDUs. The observed epidemiological connection between HIV strains circulating in Iran and Afghanistan may be due to drug trafficking and/or immigration between the two countries. This finding suggests the possible origins and transmission dynamics of HIV/AIDS within Iran and provides useful information for designing control and intervention strategies

Situational Analysis on Voluntary Counseling and Confidential Testing in HIV/AIDS Patients Referred to Behavioral Center in lmam Khomeini Hospital, Tehran, Iran

Background and aims: Behavioral counseling centers are the main health organizations which are responsible for providing treatment and care for the patients living with HIV (PLWH). HIVpositive patients receive services through a unique counseling process called voluntary counseling and confidential testing (VCCT). Although there are reports regarding VCCT evaluation from other countries, not such an evaluation was found in Iran until this study, to the best of our knowledge. The study was performed to fulfill this necessity. Methods: Using consecutive method sampling, 314 subjects were sampled from the patients referred to Behavioral Counseling Center of Imam Khomeini hospital, Tehran, Iran. A combination of process and output evaluation of VCCT was performed in the biggest Behavioral Counseling Center of Iran at Imam Khomeini hospital, Tehran, Iran. Data were analyzed using descriptive statistics (percentages and averages). Results: Participants’ response rate was 95.54%. Two shortcomings were found in the counseling process. Cronbach alpha reliability coefficient for this scale was 0.899, which was a desirable reliability for the questionnaire. As the main finding of the study, 48.33% of patients were not using antiretroviral medications regularly. An average number of patients (2.88) had HIV related stigma and fear of disclosure. In a quantitative study before testing in the study, it has been found that HIV patients did not have adequate information about their disease. Conclusion: Defects in the consultation process for the patients with HIV infection in the hospital were concluded. The quantity of consulting services for patients was in low level; therefore it is essential to improve consulting services for health promotion of the HIV patients

Un-rooted phylogenetic tree of CRF_AD whole genome sequences from Iran and Afghanistan, constructed using Kimura 2-parameter matrices and Neighbor-Joining method.

<p>Un-rooted phylogenetic tree of CRF_AD whole genome sequences from Iran and Afghanistan, constructed using Kimura 2-parameter matrices and Neighbor-Joining method.</p

HIV-1 subtype classification by gene region of HIV-1 Iranian sequences from the HIV databases (www.hiv.lanl.gov).

<p>HIV-1 subtype classification by gene region of HIV-1 Iranian sequences from the HIV databases (<a href="http://www.hiv.lanl.gov" target="_blank">www.hiv.lanl.gov</a>).</p