HIV-1 Subtype Distribution and Diversity Over 18 Years in Rakai, Uganda

Lamers SL, Rose R, Cross S, Rodriguez CW, Redd AD, Quinn TC, Serwadda D, Kagaayi J, Kigozi G, Galiwango R, Gray RH, Grabowski MK, Laeyendecker O

The Rakai Community Cohort Study in south central Uganda has surveyed people aged 15-49 since 1994. Antiretroviral therapy (ART) was introduced in 2004. HIV p24 and gp41 subtype distribution and viral diversity were studied from blood samples collected at three surveys in 1994-1995, 2002-2003, and 2008-2009, which were compared with a new survey round from 2011 to 2012. These included 1364 HIV+ individuals. For both p24 and gp41 domains, the genetic diversity within subtypes A and D was significantly increasing in the pre-ART era and decreased between the last two survey rounds in the ART era ( < .01). This study suggests that despite ongoing mixing of viral subtypes, an association with the introduction of ART to a reduction of intra-subtype viral genomic diversity may be occurring, which can be explored in ongoing studies.