Identification of a complex env subtype E HIV type 1 virus from the Democratic Republic of Congo, recombinant with A, G, H, J, K, and unknown subtypes

Up to now, all known env subtype E viruses (CRF01-AE) have had the same mosaic structure with subtype A, and no other env subtype E HIV-1 viruses with non-A subtypes in their genomes have been described. In this report, we describe the full-length genome sequence of an env subtype E isolate with a recombinant genome different from the prototype CRF01-AE strains. The 97CD-KTB-49 strain, obtained from a tuberculosis patient in Kinshasa, has a complex mosaic genome involving subtypes A, E, G, H, J, K, and several unknown fragments. The U sequences formed well-separated clusters together with previously described unknown fragments from CRF04-cpx (subtype I), and from Z321, the oldest intersubtype recombinant isolated in 1976 in the Democratic Republic of Congo. The complex recombinant virus from our study is not an isolated strain ; partial sequencing of a second strain, 97CD-KFE45, confirmed the breakpoints observed in the 97CD-KTB-49 strain in the regions sequenced. The complexity of these recombinant strains suggests a longstanding presence of subtype E in Central Africa. (Résumé d'auteur

Near-full-length genome sequencing of divergent African HIV type 1 subtype F viruses leads to the identification of a new HIV type 1 subtype designated K

We recently reported a high divergence among African subtype F strains. Three well-separated groups (F1, F2, and F3) have been shown based on the phylogenetic analysis of the p24 gag and envelope sequences with genetic distances similar to those observed for known subtypes. In this study, we characterized the near-full-length genomes of two strains from epidemiological unlinked individual belonging to each of the subgroups : F1 (96FR-MP411), F2 (95CM-MP255 and 95CM-MP257), and F3 (96CM-MP535 and 97ZR-EQTB11). Phylogenetic analysis of the near-full-length sequences and for each of the genes separately showed the same three groups, supported by high bootstrap values. Diversity plotting, BLAST subtyping, and bootstrap plotting confirmed that the divergent F strains correspond to nonrecombinant viruses. The divergence between F1 and F2 is consistently lower than that seen in any other intersubtype comparison, with the exception of subtypes B and D. Based on all the different analyses, we propse to divide subtype F into two subclades, with F1 gathering the known subtype strains from Brazil and Finland, and our African strain (96FR-MP411), and F2 containing the 95CM-MP255 and 95CM-MP257 strains from Cameroon. The F3 strains, 97ZR-EQTB11 from the Democratic Republic of Congo and 96CM-MP535 from Cameroon, meet the criteria of a new subtype designated as K. The equidistance of subtype K to the other subtypes of HIV-1 suggests that this subtype existed as long as the others, the lower distance between B and D, and between F1 and F2 suggest a more recent subdivision for these latter strains. (Résumé d'auteur

AIDS em mulheres adultas no município do Rio de Janeiro

Este trabalho apresenta as principais características epidemiológicas descritivas da distribuição de AIDS em mulheres adultas no Município do Rio de Janeiro, ao longo da década de oitenta. Pode-se observar uma participação crescente das mesmas, com elevadas taxas de incidência comparativamente com coeficientes para todo o Brasil, bem como para o Canadá. A contaminação transfusional, predominante no início da epidemia, vem cedendo lugar à transmissão sexual e por utilização de drogas endovenosas. Observa-se, também, uma distribuição espacial definida na ocorrência dos casos, com participação crescente das mulheres jovens. O trabalho ressalta a importância da tuberculose como segunda causa de complicação mais freqüente entre as infecções oportunistas observadas. Finalmente, são apontadas algumas das questões cruciais a serem abordadas no futuro, tendo em vista a compreensão e o controle na difusão da epidemia no grupo estudado.<br>This paper presents the main epidemiological characteristics of AIDS cases observed among adult women in Rio de Janeiro Municipality (Rio) during 1980-89. Higher incidence rates as compared to Brazilian and Canadian women, rising participation of either sexual transmission and EV drug addiction and an increasing involvement of young women were also observed. The disease does not present a random spatial distribution in Rio, and case clusters in definite high risks areas were shown. Tuberculosis was found to be the second most frequent opportunistic infection detected among cases. Finally, some of the main trends and questions related to AIDS control among women in the studied area are discussed

Bone marrow transplantation in sickle cell anaemia.

Sickle cell anaemia is still responsible for severe crippling and death in young patients living in developing countries. Apart from prophylaxis and treatment of infections, no active treatment can be safely proposed in such areas of the world. Therefore a bone marrow transplantation was performed in 12 patients staying in Belgium and planning to return to Africa. Twelve patients, aged between 11 months and 23 years (median 4 years), underwent a HLA identical bone marrow transplantation. The conditioning regimen included oral busulphan for four consecutive days (4 mg/kg) followed by four days of intravenous cyclophosphamide (50 mg/kg). In 10 patients the engraftment was rapid and sustained. A further patient suffered transient red cell hypoplasia and another underwent a second bone marrow transplantation from the same donor at day 62 because of graft rejection. All patients are alive and well with a follow up ranging from 9-51 months (median 27 months). In all cases a complete cessation of vaso-occlusive episodes and haemolysis was observed as was a change in the haemoglobin pattern in accordance with the donor's electrophoretic pattern