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Background: HIV/AIDS is
the principal pandemic in the world today. Two
viral types (HIV-1 and HIV-2), with numerous groups (M, N and O for HIV-1 and A
through H for HIV-2) have emerged. These have further proliferated into
numerous subtypes, sub-subtypes and circulating recombinant forms (CRF) over
the last 30 years. HIV-1 variants
circulate together within a geographical region providing an opportunity for
recombination of viral strains within infected individuals. In Kenya, at least nine different
genetic HIV-1 subtypes and several recombinant forms have been defined within
group M, which accounts for the majority of cases in the AIDS pandemic. Objective: To determine the genetic diversity of
HIV-1 in the western region of Kenya bordering Uganda. Methodology: A cross
sectional study was carried out at Busia District Hospital between 2007 and
2009. A total of 75 patients were sampled randomly from a cohort of 1000
clients on antiretroviral therapy. Blood samples were analysed at the HIV
Laboratory, Kenya Medical Research Institute, Nairobi, Kenya. PCR was carried
out on the Pol region of HIV, sequenced and analysed
by BLAST for subtypes. Results: BLAST analysis revealed the following
circulating subtypes: 40/75 (53.30%) were HIV-1 group M subtype A1; 21/75
(28.0%) were subtype D; 5/75 (6.7%) were subtype G; 4/75 (5.30%) were subtype
C; and 2/75 (2.70%) were subtype A2. Only one isolate was identified for the
other subtypes viz: 1/75
(1.30%) resembled subtype B; 1/75 (1.30%) was A1/C, and 1/75 (1.30%) was A1/D.
Conclusion: The study showed increasing HIV-1 diversity along the Kenya-Uganda
border with the emergence of A1/C and A1/D recombinants. Such HIV-1 diversityvis a vis the recent expanded access to
antiretroviral therapy in resource limited settings calls for continuous
evaluation of anti-HIV regimens. There is
need therefore, for regular surveillance and monitoring for mutations that are
likely to lead to drug resistance if we have to achieve successful treatment
outcomes.
KEYWORDS
Cite this paper
Adungo, F. , Gicheru, M. , Adungo, N. , Matilu, M. ,
Lihana, R. and Khamadi, S. (2014) Diversity of Human
Immunodeficiency Virus Type-1 Subtypes in Western Kenya. World Journal of AIDS, 4, 365-372. doi: 10.4236/wja.2014.44043.
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