Short Communication: HIV Type 1 Subtypes in Malaysia, Determined with Serologic Assays: 1992–1996

Abstract

We investigated the molecular epidemiology of HIV-1 subtypes in Malaysia among injecting drug users (IDUs) and sexual transmission risk groups, using serologic and genetic techniques. Frozen sera collected at a general hospital, a blood bank, several drug treatment centers, and an STD clinic in Kuala Lumpur, between 1992 and 1996, were investigated retrospectively. V3 peptide serotyping and monomeric gp120 capture serotyping were used to study 89 known HIV-1-infected subjects. The methods differentiate subtypes B, E, and C. V3 peptide and gp120 capture results were comparable. No subtype C-specific reactive sera were found; one specimen was dually reactive for subtypes C and B, using the V3 peptide ELISA; and four were durally reactive for subtypes E and C using this assay. Genotypic analysis of HIV-1 gag RNA in serum was done on a subset of subjects and confirmed serologic findings. HIV-1 subtypes differed significantly by risk category: of 53 IDUs, 29 (55%) were infected with subtype B and 19 (36%) were infected with subtype E, 3 (6%) were dually reactive, and 2 (4%) were not typable. Of 36 persons with heterosexual risks, 29 (81%) were infected with subtype E, 5 (14%) were infected with subtype B, and 2 (5%) were not typable. Persons with IDU risks were significantly more likely to be infected with subtype B than were those with sexual risks (OR 5.89; 95% CI, 1.94-18.54; p < 0.001). Subtypes B and E of HIV-1 appear to predominate in Malaysia; subtype B was more prevalent among IDUs; subtype E was more prevalent among all other groups. These results may have important HIV-1 vaccine implications.

Enhanced HIV-1 surveillance using molecular epidemiology to study and monitor HIV-1 outbreaks among intravenous drug users (IDUs) in Athens and Bucharest

“…Large differences exist across Europe: in Western Europe the proportion of HIV-1 diagnoses among IDUs was 5.1%, in Central Europe 7.3%, and in Eastern Europe 33.6% (ecdc/WHO). In the 80s and 90s, several HIV-1 outbreaks were reported among IDUs in Europe, and specifically in Eastern Europe (Latvia, Russia, Estonia, Belarus, Azerbaijan, Armenia, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Tajikistan, Ukraine, and Uzbekistan) (Balode et al, 2012;Beyrer et al, 2009Beyrer et al, , 1998Bobkov et al, 2004a,b;Bobkova, 2013; ecdc/WHO; Kazennova et al, 2013;Laga et al, 2012;Lazouskaya et al, 2005;Mathers et al, 2010;Novitsky et al, 1998;Pandrea et al, 2001;Saad et al, 2006a,b;Sanchez et al, 2006;Uuskula et al, 2002;Zarandia et al, 2006), in Portugal (Esteves et al, 2003), Italy (Ciccozzi et al, 2007), Finland and Sweden (Kivela et al, 2007;Skar et al, 2011).…”

“…In recent years, the major reported route of infection in Romania has been heterosexual transmission. In addition to subtype F1, subtype B infections have been increasingly detected in recent years as a result of multiple introductions from other western countries (Beyrer et al, 1998;Stanojevic et al, 2012). Annually, only few new cases were reported among MSM and sporadic cases in IDUs.…”

Assessing subtypes and drug resistance mutations among HIV-1 infected children who failed antiretroviral therapy in Kelantan, Malaysia

“…3 the early phase of HiV-1 epidemic in Malaysia was characterized by the prevalence of subtypes crf01_AE and b among heterosexuals and injecting drug users (iDU), respectively. 4,5 However, in recent years, co-circulation and subsequent continual recombination events of crf01_AE and subtype b' (a subtype b variant of thai origin) have formed new radiations of novel crfs, including crf33_01b 6 and crf15_01b. 7 the state of Kelantan is located on the northeastern part of peninsular Malaysia and shares a border with thailand on the north.…”

Prevalence and pattern of drug resistance mutations among antiretroviral-treated HIV-1 patients with suboptimal virological response in Malaysia

“…The major HIV-1 subtype circulating in Kuala Lumpur is CRF01_AE, particularly among patients with heterosexual risk [10][11]. Subtype B¢ (Thai variant of subtype B) and CRF01_AE/B¢ intersubtype recombinants are also present.…”