HIV-1 variants in population-based national surveys in sub-Saharan Africa, 2015-2022.

Ghys PD., Voetsch AC., Justman JE., Patel H., Devos JR., Brown K., Ussery F., Parekh B., Mahy M., Abimiku A., Aliyu S., Aliyu G., Zuma K., Moyo S., van der Walt C., Kalimashe MN., Ndongmo CB., Kirungi WL., Arimide DA., Hemelaar J., Study Group to characterize the HIV-1 variant distribution in national surveys in sub-Saharan Africa, 2015–2022 ∗ .

ObjectiveTo describe the distribution of HIV-1 variants in population-based national surveys conducted in sub-Saharan African countries between 2015 and 2022.DesignMulticountry analysis.MethodsSixteen population-based national surveys, conducted between 2015 and 2022, were analyzed. Survey participants were eligible if HIV genotyping was successful. In most countries, people with HIV (PWH) with a recent infection, children with HIV younger than 18 months, and a country-specific selection of PWH with a nonrecent infection were included. In Nigeria and South Africa, PWH were eligible when viral load >200 or >1000 RNA copies/ml, respectively. HIV-1 variants were identified using the REGA HIV-1 & 2 Automated Subtyping Tool version 3.0. The estimated distributions of HIV-1 variants for each survey were calculated as the percentage distribution.ResultsThe sample size varied between 42 and 1434 PWH per country survey. Country distributions showed great variation, with a majority of CRF02_AG in Cameroon, Côte d'Ivoire and Nigeria; a majority of subtype A in Kenya, Rwanda, and Uganda; near equal proportions of subtype C (39%) and subtype A (37%) in Tanzania, and dominance of subtype C (>90%) in Ethiopia, Eswatini, Lesotho, Malawi, Namibia, South Africa, Zambia, and Zimbabwe. Recombinant viruses were mostly found in countries in West-Africa.ConclusionsThe distribution of HIV-1 variants by country and region in sub-Saharan Africa showed important variation. HIV-1 diversity may need to be accounted for during the development of HIV diagnostic and viral load tests, vaccines, other prevention interventions, and treatment.

DOI

10.1097/qad.0000000000004471

Type

Journal article

Publication Date

2026-02-01T00:00:00+00:00

Addresses

Independent Consultant, Switzerland.

Keywords

Study Group to characterize the HIV-1 variant distribution in national surveys in sub-Saharan Africa, 2015–2022 ∗

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