High HIV type 1 group M pol diversity and low rate of antiretroviral resistance mutations among the uniformed services in Kinshasa, Democratic Republic of the Congo

Abstract

For the first time the genetic diversity among the uniformed personnel in Kinshasa, the capital city of the Democratic Republic of Congo (DRC), a country that has experienced military conflicts since 1998 and in which the global HIV-1/M pandemic started, has now been documented. A total of 94 HIV-1-positive samples, collected in 2007 in Kinshasa garrison settings from informed consenting volunteers, were genetically characterized in the pol region (protease and RT). An extensive diversity was observed, with 51% of the strains corresponding to six pure subtypes (A 23%, C 13.8%, D, G, H, J, and untypable), 15% corresponding to nine different CRFs (01, 02, 11, 13, 25, 26, 37, 43, and 45), and 34% being unique recombinants with one-third being complex mosaic viruses involving three or more different subtypes/CRFs. Only one strain harbored a single mutation, I54V, associated with drug resistance to protease inhibitors. Due to their high mobility and potential risk behavior, HIV infections in military personnel can lead to an even more complex epidemic in the DRC and to a possible increase of subtype C.

FIG. 1.

(A) Detailed distribution of the HIV-1 variants in the military population from the DRC and schematized structure of the unique recombinant forms. The start of the pol gene and the protease and RT regions are indicated at the bottom of the figure. (B) Phylogenetic tree analysis of the 94 newly obtained pol sequences from the military population. The phylogenetic analysis was done as indicated in the text using the neighbor-joining method with 100 bootstrap resamplings on 1455 aligned bases from the gap-stripped alignment. For better clarity, the tree was drawn with the minimal number of references, i.e., without some CRFs and unique sequences not represented among the samples of the study. The bootstrap values above 80 were indicated with an asterisk at each node. The branches for the reference sequences are in black and those for the sequences of the study population are in gray. Each newly sequenced URF was highlighted in gray and the corresponding mosaic structure is shown in (A).

FIG. 1.

(A) Detailed distribution of the HIV-1 variants in the military population from the DRC and schematized structure of the unique recombinant forms. The start of the pol gene and the protease and RT regions are indicated at the bottom of the figure. (B) Phylogenetic tree analysis of the 94 newly obtained pol sequences from the military population. The phylogenetic analysis was done as indicated in the text using the neighbor-joining method with 100 bootstrap resamplings on 1455 aligned bases from the gap-stripped alignment. For better clarity, the tree was drawn with the minimal number of references, i.e., without some CRFs and unique sequences not represented among the samples of the study. The bootstrap values above 80 were indicated with an asterisk at each node. The branches for the reference sequences are in black and those for the sequences of the study population are in gray. Each newly sequenced URF was highlighted in gray and the corresponding mosaic structure is shown in (A).