- Public health researchers in Minnesota recently identified
83 persons infected with subtypes of HIV-1 that are not common in the United
States, according to a report published in the June 15 issue of The Journal
of Infectious Diseases, now available online.
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- Viral subtype identification may be important because
subtypes may differ in terms of the efficacy of potential vaccines, diagnostic
testing for HIV infection, and monitoring of the health of HIV-infected
patients. The report, by Tracy L. Sides, MPH, and colleagues of the Minnesota
Department of Health and the HIV Program at Hennepin County Medical Center,
emphasizes the need for better surveillance of HIV-1 subtypes to determine
their prevalence.
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- For the first two decades of the AIDS epidemic in the
United States, HIV-1 subtype B has been the predominant isolate throughout
the country. In recent years, non-B HIV-1 subtypes have been spreading
in parts of Europe. As Sides and colleagues explained, however, the prevalence
of subtype B and other subtypes in the United States is not known, because
subtype testing is not conducted with routine HIV/AIDS surveillance.
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- In 2003, the Minnesota Department of Health piloted HIV-1
subtyping with routine surveillance to describe and monitor non-B-subtype
HIV-1 isolates. In Minnesota, African-born persons make up less than one
percent of the population, but in 2002 accounted for 21 percent of the
state's new cases of HIV infection. Accordingly, Sides and colleagues conducted
targeted surveillance of 98 African-born HIV-infected patients to determine
the existence and variety of HIV-1 subtypes. They also conducted surveillance
on 28 non-African patients to monitor the introduction of non-B subtypes
into Minnesota.
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- All of those infected with non-B subtypes were African
immigrants attending health clinics in the Minneapolis-St. Paul area. Of
the 98 African-born HIV-1-infected patients, 87 were successfully subtyped
and 95 percent of these were infected with non-B subtypes. Seven different
subtypes were identified, all consistent with strains endemic to the patients'
regions of birth. Of the non-African HIV-1-infected patients, 25 were successfully
subtyped and all were infected with subtype B.
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- The researchers believe that their results underestimate
the prevalence of non-B subtypes in Minnesota because recent immigrants
are less likely than assimilated immigrants to have access to the American
health care system. Since their estimates are based solely on patients
from health care facilities, they probably missed recent immigrants with
HIV infection.
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- In an accompanying editorial, Diane Bennett, MD, MPH,
of the Centers for Disease Control and Prevention explained that this study
is important because few such investigations of U.S. subtype prevalence
have been conducted, and because the results have national public health
implications. "The findings of a high prevalence of non-B subtypes
in a state where African-born individuals make up less than one percent
of the population," she said, "suggest that it may be time to
consider implementing HIV subtype surveillance in states with larger immigrant
populations and throughout the United States."
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- http://www.idsociety.org
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- Patricia A. Doyle, PhD
- Please visit my "Emerging Diseases" message
board at: http://www.clickitnews.com/ubbthreads/postlist.php?
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- Zhan le Devlesa tai sastimasa
- Go with God and in Good Health
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