The HIV-1 Subtype B Epidemic in French Guiana and Suriname Is Driven by Ongoing Transmissions of Pandemic and Non-pandemic Lineages

Abstract

The HIV-1 subtype B epidemic in French Guiana and Suriname is characterized by the co-circulation of the globally disseminated “BPANDEMIC” lineage and of non-pandemic subtype B lineages of Caribbean origin (BCAR). To reconstruct the spatiotemporal pattern of spread of those viral lineages circulating in these two countries, a total of 361 HIV-1 subtype B pol sequences recovered from treatment-naive adult patients from French Guiana and Suriname between 2006 and 2012 were combined with BPANDEMIC and BCAR reference sequences. Major Guianese/Surinamese BPANDEMIC and BCAR lineages were identified by Maximum Likelihood phylogenetic analysis and the spatiotemporal and demographic parameters estimated using a Bayesian coalescent-based method. We detected four BCAR and three BPANDEMIC transmission chains of large size that together comprise most pandemic and non-pandemic subtype B sequences from French Guiana (≥52%) and Suriname (≥70%) here analyzed. These major lineages were probably introduced into French Guiana and Suriname from the Caribbean (BCAR) and North/South America (BPANDEMIC) between the middle 1970s and the late 1980s and spread among populations from both countries with roughly comparable demographic growth rates. We detected a significant trend for higher viral loads and higher proportion of homosexual/bisexual men among subjects infected with BPANDEMIC relative to BCAR strains in French Guiana. These results show that the HIV subtype B epidemic in French Guiana and Suriname has been driven by multiple active BCAR and BPANDEMIC transmission chains that arose since the middle 1970s onward and operate in both countries simultaneously. Although no significant differences in the epidemic potential of major BCAR and BPANDEMIC lineages were observed, relevant associations between the infecting subtype B lineage and epidemiological and clinical characteristics were detected in French Guiana.

Phylogeographic Analyses Reveal the Early Expansion and Frequent Bidirectional Cross-Border Transmissions of Non-pandemic HIV-1 Subtype B Strains in Hispaniola

“…The HIV-1 epidemic in Hispaniola is dominated by subtype B (Nadai et al, 2009; Myers et al, 2012; Lopez et al, 2015). Genetic evidence suggests that the subtype B epidemic in Hispaniola, as in many other Caribbean countries, is mainly driven by the transmission of multiple early divergent non-pandemic subtype B lineages (designated “B CAR ”), although the worldwide disseminated “B PANDEMIC ” lineage also circulates (Cabello et al, 2014, 2015; Divino et al, 2016; Bello et al, 2018). The early dissemination dynamics of the HIV-1 subtype B epidemics between Haiti and the Dominican Republic remain largely unknown.…”

Few amino acid signatures distinguish HIV-1 subtype B pandemic and non-pandemic strains

“…In summary, albeit some mutations fixed in the HIV-1 B PANDEMIC ancestral strain could potentially have some phenotypic impact on viral transmissibility, the absence of stringent AAs distinguishing modern B CAR and B PANDEMIC variants and the similar amino acid composition between B CAR and other group M subtype pandemic variants at key sites indicates that viral genetic determinants were probably not the main factor shaping the divergent pattern of geographic spread of B CAR and B PANDEMIC variants. The successful dissemination of B CAR strains in some Caribbean countries that exhibit the highest HIV-1 prevalence rates outside of Africa [6,11] also argues against the hypothesis of a reduced B CAR viral fitness. These results support that stochastic events leading to the introduction of B PANDEMIC ancestor into globally connected populations were the most probable driving force behind its pandemic dissemination and substantiate the crucial need for continued molecular surveillance of HIV-1 transmission on key populations worldwide.…”

“…Viral transmissibility correlated with the plasma viremia during chronic infection [ 14 ], and some studies found that plasma viremia within subtype B is highly heritable, thus indicating that this trait depends strongly on the virus genotype [ 15 – 18 ]. Notably, a significant trend for higher viral loads among subjects infected with B PANDEMIC relative to B CAR strains was recently described in French Guiana [ 11 ] which may have played a role in the differential transmissibility of the two viral strains. Studies of molecular signatures in non-pandemic subtype B lineages, however, have been limited so far to the analysis of the env gene of B CAR strains circulating in Trinidad and Tobago [ 19 , 20 ].…”

“…The second major event took place when one subtype B strain spread from the Caribbean to the U.S. around the late 1960s and got access to high-risk transmission networks globally connected that fueled the establishment of a pandemic clade (B PANDEMIC ) responsible for most of the infections of this subtype worldwide [ 8 , 9 ]. In contrast, other non-pandemic subtype B lineages (B CAR ) spread and circulates at high prevalence in several Caribbean islands and the Northern South American region, but were not successfully disseminated worldwide [ 4 , 6 , 8 – 11 ].…”

Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana

“…As a French territory, French Guiana has had access to diagnostic tests and treatments available in mainland France, and has been following the regular updates in the French National expert recommendations for HIV [ 5 ]. However, the Caribbean and South American connections, and the Amazonian pathogen ecosystem has led to specificities that are not always included in the National Guidelines [ 6 , 7 , 8 ]. Perhaps one of the greatest particularities is the high incidence of disseminated histoplasmosis, the main AIDS-defining infection in French Guiana [ 9 , 10 ].…”