HIV-1 Non-Group M Strains and ART

Abstract

To eliminate HIV infection, there are several elements to take into account to limit transmission and break viral replication, such as epidemiological, preventive or therapeutic management. The UNAIDS goals of screening, treatment and efficacy should allow for this elimination if properly followed. For some infections, the difficulty is linked to the strong genetic divergence of the viruses, which can impact the virological and therapeutic management of patients. To completely eliminate HIV by 2030, we must therefore also be able to act on these atypical variants (HIV-1 non-group M) which are distinct from the group M pandemic viruses. While this diversity has had an impact on the efficacy of antiretroviral treatment in the past, recent data show that there is real hope of eliminating these forms, while maintaining vigilance and constant surveillance, so as not to allow more divergent and resistant forms to emerge. The aim of this work is therefore to share an update on the current knowledge on epidemiology, diagnosis and antiretroviral agent efficacy of HIV-1 non-M variants.

Keywords: ART; HIV-1; elimination; genetic variants.

Figure 1

Phylogenetic relationships between the HIV-1, SIVcpz and SIVgor lineages (reprinted from reference [6] with permission of the publisher).

Figure 2

Molecular epidemiology of HIV-1 non-group M. The three maps represent the worldwide distribution of the HIV-1/O, HIV-1/N and HIV-1/P variants, reprinted from [22]. * One case of group N infection was detected in France but has likely its origin in Togo [23].

Figure 3

Recombination pattern of five HIV-1/MO recombinant forms. The group origin is indicated in red (group M) and blue (group O). This genomic representation was created using the Recombinant HIV Drawing Tool (http://www.hiv.lanl.gov/content/sequence/DRAW_CRF/recom_mapper.html accessed on 3 february 2023).