Emergence of HIV-1 CRF01_AE/B unique recombinant forms in Kuala Lumpur, Malaysia

Tee, Kok Keng; Pon, Chee Keong; Kamarulzaman, Adeeba; Ng, Kee Peng

doi:10.1097/00002030-200501280-00003

Cited by 30 publications

(26 citation statements)

References 31 publications

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“…Subtype distribution among the studied subjects were CRF01_AE (86.1%), subtype B¢ (8.3%) and CRF01_AE/B¢ intersubtype recombinants (5.6%) (phylogenetic trees not shown). The predominance of CRF01_AE was consistent among patients with heterosexual risk (p=0.014) [10].…”

Section: Resultsmentioning

confidence: 68%

“…Plasma HIV-1 RNA levels were monitored by reverse transcription-PCR (COBAS AMPLICOR HIV-1 MONITOR Version 1.5; Roche Diagnostics GmbH, Mannheim, Germany) before the nucleotide sequences of RT and protease genes were determined by regular in-house nested PCR and direct sequencing described previously [10]. Samples with plasma VL of >10 3 copies/ ml (and a few with 10 2 -10 3 copies/ml) were genotypically analyzed.…”

Section: Methodsmentioning

confidence: 99%

“…In this study, M41L, K65R, D67N, insertion 69, K70R, L74V, L100I, K103N, V106A/M, Q151M, Y181C/I, M184V/I, Y188C/L/H, G190A/S, L210W, T215Y/F, K219Q/E, and P225H in the RT gene and D30N, V32I, M46I/L, I47V/A, G48V, I50V, V82A/T/F/ S, I84V, and L90M in the protease gene were considered as major drug resistance mutations. In addition, HIV-1 subtypes were determined using RT and protease genes by phylogenetic methods described previously [10].…”

Section: Methodsmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Tee

Kamarulzaman

2006

Med Microbiol Immunol

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To assess the prevalence of major drug resistance mutations in antiretroviral (ARV)-treated patients with detectable viral load (VL) in Kuala Lumpur, Malaysia, genotypic resistance testing was performed among treated human immunodeficiency virus type 1 (HIV-1) patients attending the University Malaya Medical Center between July 2003 and November 2004. The reverse transcriptase (RT) and protease genes from 36 plasma samples with detectable VL were examined for major mutations associated with ARV resistance as reported by the International AIDS Society-USA Drug Resistance Mutations Group. The prevalence of patients with at least one major mutation conferring drug resistance to nucleoside RT inhibitors (NRTIs), non-NRTIs (NNRTIs) or protease inhibitors (PIs) was 77.8%. In the RT gene, the frequency of mutations associated with NRTIs and NNRTIs resistance was 52.8 and 63.9%, respectively, with M184V and K103N mutations being selected most frequently by these drugs. A patient with Q151M mutation complex was also detected. Twenty-two percent of the patients had mutations associated with PIs. The following pattern of prevalence of ARV-resistant HIV-1 variants was observed: NNRTI-resistant > NRTI-resistant > PI-resistant. The prevalence of major drug resistance mutations among ARV-treated patients with detectable VL is high in Kuala Lumpur. Genotypic drug resistance testing is therefore important for monitoring patients experiencing ARV regimen failure.

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Section: Resultsmentioning

confidence: 68%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Tee

Kamarulzaman

2006

Med Microbiol Immunol

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“…4 The cocirculation of the two different strains in this region led to the generation of more complex recombinant strains that emerged in almost every country in Southeast Asia. [5][6][7][8][9][10] Furthermore, some of the recombinant strains have spread widely in populations and have become CRFs. Up to now, five CRFs, originated from CRF01_AE and subtype B¢ lineages, have been reported in Southeast Asia: CRF15_01B 11 and CRF34_01B 12 from Thailand, CRF33_01B 13 and CRF48_01B 14 from Malaysia, and CRF51_01B 15 from Singapore.…”

mentioning

confidence: 99%

Identification of a Novel HIV Type 1 Circulating Recombinant Form (CRF52_01B) in Southeast Asia

Liu

Bao

et al. 2012

AIDS Research and Human Retroviruses

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Thirty HIV-1 URF_01AE/ B¢ complete or nearly full-length genome sequences sampled within Southeast Asia were obtained from the Los Alamos HIV Sequence Database. Phylogenetic and recombinant analyses revealed that three sequences indeed displayed the identical recombinant structure. Of note, the three subjects, harboring novel CRF01_AE/B recombinants, did not have apparent epidemiological linkage. They fulfilled the criteria for the designation of a new circulating recombinant form (CRF) and constituted the 52nd CRF identified in the worldwide HIV-1 pandemic. In this chimera, two short subtype B segments were inserted into a backbone of CRF_01AE. The breakpoints corresponded to HXB2 nucleotide positions 2930, 3251, 8521, and 9004 approximately. This CRF is the first one identified by neatening and analyzing the sequences already presented in the Los Alamos HIV Sequence Database. This indicates that we should pay attention not only to explicit subtype sequences but also to those classified as a unique recombinant form (URF) so far.M utation, coupled with recombination, has resulted in the extensive genetic diversity of HIV-1. The high genetic diversity of HIV-1 allows its classification into groups, subtypes, subsubtypes, and circulating recombinant forms (CRFs).1 Group M HIV-1 dominates the AIDS pandemic with at least nine subtypes (A to D, F to H, J, and K) and multiple intersubtype recombinants. Currently, a total of 51 CRFs have been represented in the Los Alamos HIV database web site (http://hiv-web.lanl.gov/CRFs/CRFs.html).Meanwhile multiple unique recombinant forms (URFs) have been reported in many regions around the world.Southeast Asia was thought to be an epicenter of the HIV-1 epidemic in Asia. The AIDS epidemic in this region was initiated by two different subtype strains in two separated risk groups, with subtype B among injecting drug users (IDUs) and CRF01_AE among those heterosexually exposed, throughout the early phase.2,3 CRF01_AE can clearly cross over from the heterosexual epidemic to IDUs and by 1995 it also became the predominant subtype in IDUs. 4 The cocirculation of the two different strains in this region led to the generation of more complex recombinant strains that emerged in almost every country in Southeast Asia.5-10 Furthermore, some of the recombinant strains have spread widely in populations and have become CRFs. Up to now, five CRFs, originated from CRF01_AE and subtype B¢ lineages, have been reported in Southeast Asia: CRF15_01B 11 and CRF34_01B 12 from Thailand, CRF33_01B 13 and CRF48_01B 14 from Malaysia, and CRF51_01B 15 from Singapore. The HIV-1 epidemic in this region has now become increasingly heterogeneous.The extensive use of complete and nearly full-length genome sequencing of HIV-1 strains has provided a powerful and accurate approach to the molecular epidemiology of regional epidemics. Consequently, the number of complete or nearly full-length HIV-1 genome sequences was growing larger and larger. The majority of these can be classified as subtypes and CRFs def...

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Molecular diversity of HIV‐1 and surveillance of transmitted drug resistance variants among treatment Naïve patients, 5 years after active introduction of HAART in Kuala Lumpur, Malaysia

Ong

Razak

Lee

et al. 2013

Journal of Medical Virology

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Expansion of antiretroviral treatment programs have led to the growing concern for the development of antiretroviral drug resistance. The aims were to assess the prevalence of drug resistant HIV-1 variants and to identify circulating subtypes among HAART-naïve patients. Plasma specimens from N = 100 HIV+ HAART-naïve adult were collected between March 2008 and August 2010 and viral RNA were extracted for nested PCR and sequenced. PR-RT sequences were protein aligned and checked for transmitted drug resistance mutations. Phylogenetic reconstruction and recombination analysis were performed to determine the genotypes. Based on the WHO consensus guidelines, none of the recruited patients had any transmitted drug resistance mutations. When analyzed against the Stanford guidelines, 35% of patients had at least one reported mutation that may reduce drug susceptibility to PI (24%), NRTI (5%), and NNRTI (14%). The commonly detected mutation that may affect current first line therapy was V179D (3%), which may lead to reduced susceptibility to NNRTI. The predominant circulating HIV-1 genotypes were CRF01_AE (51%) and CRF33_01B (17%). The prevalence of unique recombinant forms (URF) was 7%; five distinct recombinant structures involving CRF01_AE and subtype B' were observed, among them a cluster of three isolates that could form a novel circulating recombinant form (CRF) candidate. Transmitted drug resistance prevalence among HAART-naïve patients was low in this cohort of patients in Kuala Lumpur despite introduction of HAART 5 years ago. Owing to the high genetic diversity, continued molecular surveillance can identify the persistent emergence of HIV-1 URF and novel CRF with significant epidemiological impact.

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Emergence of HIV-1 CRF01_AE/B unique recombinant forms in Kuala Lumpur, Malaysia

Cited by 30 publications

References 31 publications

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

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

Identification of a Novel HIV Type 1 Circulating Recombinant Form (CRF52_01B) in Southeast Asia

Molecular diversity of HIV‐1 and surveillance of transmitted drug resistance variants among treatment Naïve patients, 5 years after active introduction of HAART in Kuala Lumpur, Malaysia

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