High frequency of non-B subtypes in newly diagnosed HIV-1 infections in Switzerland

HIV-1 subtypes were determined in newly diagnosed residents of Switzerland. Blood was anonymously collected from patients with a first confirmed posit ive HIV-1 test result. Viral DNA from the env V3-V5 region was amplified by nested polymerase chain reaction (PCR) and screened for subtype B by heter oduplex mobility assay. All amplicons not identified as B were sequenced. F rom November 1996 to February 1998, 206 samples were analyzed. Main transmi ssion risks were unprotected heterosexual (55.7%) or homosexual (27.1%) sex ual contact or intravenous drug use (12.9%). Subtype B dominated in patient s of Swiss, other European, American, or Asian citizenship; particularly hi gh frequencies were found in homosexuals (97%) and drug users (94%). Non-B subtypes including A, C, D, E, F, G, H, a possible B/F recombinant, and a s equence related to J were present in 28.2% (95% confidence interval [CI], 2 2.9%-35.0%). Non-B were frequent in African citizens (95%), heterosexually infected individuals (44%), and women (43%). Heterosexually infected Swiss males harbored non-B strains in 18% and females in 33%. The results documen t a change in the epidemiology of newly diagnosed HIV-1 infections in Switz erland: predominance of heterosexual transmission and a high frequency of n on-B subtypes.