TY - JOUR
T1 - Extensive genetic diversity of HIV-1 in incident and prevalent infections among Malaysian blood donors
T2 - Multiple introductions of HIV-1 genotypes from highly prevalent countries
AU - Chow, Wei Zhen
AU - Bon, Abdul Hamid
AU - Keating, Sheila
AU - Anderios, Fread
AU - Halim, Hazwan Abdul
AU - Takebe, Yutaka
AU - Kamarulzaman, Adeeba
AU - Busch, Michael P.
AU - Tee, Kok Keng
N1 - Publisher Copyright:
© 2016 Chow et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2016/8
Y1 - 2016/8
N2 - Transfusion-transmissible infections including HIV-1 continue to pose major risks for unsafe blood transfusions due to both window phase infections and divergent viruses that may not be detected by donor screening assays. Given the recent emergence of several HIV-1 circulating recombinant forms (CRFs) in high-risk populations in the Southeast Asia region, we investigated the genetic diversity of HIV-1 among the blood donors in Kuala Lumpur, Malaysia. A total of 211 HIV-positive plasma samples detected among 730,188 donations to the National Blood Centre between 2013 and 2014 were provided (90.5% male, median age: 27.0 years old). Recent or long-term infection status at the time of donation was determined using a limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA). HIV-1 gagpol genes were amplified and sequenced from residual plasma for 149 cases followed by genotype determination using phylogenetic and recombination analyses. Transmitted antiretroviral resistance mutations were not observed among the blood donors, among which 22.7% were classified as recent or incident infections. Major circulating HIV-1 genotypes determined by neighbour-joining phylogenetic inference included CRF01-AE at 40.9% (61/149), CRF33-01B at 21.5% (32/149), and subtype B at 10.1% (15/149). Newly-described CRFs including CRF54-01B circulated at 4.0%, CRF74-01B at 2.0%, and CRF53-01B and CRF48-01B at 0.7% each. Interestingly, unique HIV-1 genotypes including African subtype G (8.7%), CRF45-cpx (1.3%), CRF02-AG (0.7%) and CRF07-BC (0.7%) from China were detected for the first time in the country. A cluster of subtype G sequences formed a distinct founder sub-lineage within the African strains. In addition, 8.7% (13/149) of HIV-infected donors had unique recombinant forms (URFs) including CRF01-AE/B' (4.7%), B'/C (2.7%) and B'/G (1.3%) recombinants. Detailed analysis identified similar recombinant structures with shared parental strains among the B'/C and B'/G URFs, some of which were sequenced fromrecently infected individuals, indicating the possible emergence and on-going spread of foreign clades of CRF candidates among the local population. The findings demonstrate extensive molecular complexity of HIV-1 among the infected blood donors in Malaysia, driven in part by the increased spread of recently described CRFs and multiple introductions of previously unreported genotypes from highly prevalent countries.
AB - Transfusion-transmissible infections including HIV-1 continue to pose major risks for unsafe blood transfusions due to both window phase infections and divergent viruses that may not be detected by donor screening assays. Given the recent emergence of several HIV-1 circulating recombinant forms (CRFs) in high-risk populations in the Southeast Asia region, we investigated the genetic diversity of HIV-1 among the blood donors in Kuala Lumpur, Malaysia. A total of 211 HIV-positive plasma samples detected among 730,188 donations to the National Blood Centre between 2013 and 2014 were provided (90.5% male, median age: 27.0 years old). Recent or long-term infection status at the time of donation was determined using a limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA). HIV-1 gagpol genes were amplified and sequenced from residual plasma for 149 cases followed by genotype determination using phylogenetic and recombination analyses. Transmitted antiretroviral resistance mutations were not observed among the blood donors, among which 22.7% were classified as recent or incident infections. Major circulating HIV-1 genotypes determined by neighbour-joining phylogenetic inference included CRF01-AE at 40.9% (61/149), CRF33-01B at 21.5% (32/149), and subtype B at 10.1% (15/149). Newly-described CRFs including CRF54-01B circulated at 4.0%, CRF74-01B at 2.0%, and CRF53-01B and CRF48-01B at 0.7% each. Interestingly, unique HIV-1 genotypes including African subtype G (8.7%), CRF45-cpx (1.3%), CRF02-AG (0.7%) and CRF07-BC (0.7%) from China were detected for the first time in the country. A cluster of subtype G sequences formed a distinct founder sub-lineage within the African strains. In addition, 8.7% (13/149) of HIV-infected donors had unique recombinant forms (URFs) including CRF01-AE/B' (4.7%), B'/C (2.7%) and B'/G (1.3%) recombinants. Detailed analysis identified similar recombinant structures with shared parental strains among the B'/C and B'/G URFs, some of which were sequenced fromrecently infected individuals, indicating the possible emergence and on-going spread of foreign clades of CRF candidates among the local population. The findings demonstrate extensive molecular complexity of HIV-1 among the infected blood donors in Malaysia, driven in part by the increased spread of recently described CRFs and multiple introductions of previously unreported genotypes from highly prevalent countries.
UR - http://www.scopus.com/inward/record.url?scp=84991224693&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0161853
DO - 10.1371/journal.pone.0161853
M3 - Article
C2 - 27575746
AN - SCOPUS:84991224693
SN - 1932-6203
VL - 11
JO - PLoS ONE
JF - PLoS ONE
IS - 8
M1 - e0161853
ER -