Distribution of HIV-1 subtypes among HIV-seropositive patients in the interior of Cote d'Ivoire

Limited data exist on the distribution of HIV-I subtypes in Cote d'Ivoire. The aim of this study is to describe the distribution of genetic subtypes o f HIV-I strains in six regions of Cote d'Ivoire, In 1997, we consecutively collected blood from 172 HIV-l-infected patients from six regional tubercul osis treatment centers. Peripheral blood mononuclear cells (PBMCs) from the se people were analyzed by a restriction fragment-length polymorphism (RFLP ) assay that involves a sequential endonuclease digestion of a 297-base pai r polymerase chain reaction (PCR) fragment; plasma samples were tested by a V3-loop peptide enzyme immunoassay (PEIA). DNA sequencing of the protease or env genes was performed on all samples discordant in the two assays as w ell as a random sample of the concordant subtyped samples. Of 172 specimens , 3 were PCR-negative, and 169 were putatively classified as subtype A by R FLP. The 3 PCR-negative samples were unequivocally subtyped A by PEIA. Of t he 169 RFLP subtype A samples, 159 (94%) were subtyped A by PEIA. Of the 10 discordant samples, PEIA testing classified 3 as subtype C, 2 as D, and 5 as F. Sequencing of the env gene classified these samples as 1 subtype At 4 Ds, and 5 Gs. Thus, 163 (95%) of the specimens were subtype A, 3 subtype D , 3 subtype G, 1 A/D, and 1 A/G (IbNG) circulating recombinant forms (CRF). In conclusion, most HIV-1-infected tuberculosis patients throughout the in terior of Gate d'Ivoire are infected with HIV-1 subtype A, which are very l ikely the A/G (IbNG) CRF. The uniform distribution of this subtype makes Co te d'Ivoire a potential site fur vaccine trials.