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HIV-1 variants in population-based national surveys in sub-Saharan Africa, 2015-2022

Ghys, Peter D ; Voetsch, Andrew C ; Justman, Jessica E ; Patel, Hetal ; Devos, Joshua R ; Brown, Kristin ; Ussery, Faith ; Parekh, Bharat ; Mahy, Mary and Abimiku, Alash'le , et al. (2026) In AIDS (London, England)
Abstract

OBJECTIVE: To describe the distribution of HIV-1 variants in population-based national surveys conducted in sub-Saharan African countries between 2015 and 2022.

DESIGN: Multicountry analysis.

METHODS: Sixteen population-based national surveys, conducted between 2015 and 2022, were analyzed. Survey participants were eligible if HIV genotyping was successful. In most countries, people with HIV (PWH) with a recent infection, children with HIV younger than 18 months, and a country-specific selection of PWH with a nonrecent infection were included. In Nigeria and South Africa, PWH were eligible when viral load >200 or >1000 RNA copies/ml, respectively. HIV-1 variants were identified using the REGA HIV-1 & 2 Automated... (More)

OBJECTIVE: To describe the distribution of HIV-1 variants in population-based national surveys conducted in sub-Saharan African countries between 2015 and 2022.

DESIGN: Multicountry analysis.

METHODS: Sixteen population-based national surveys, conducted between 2015 and 2022, were analyzed. Survey participants were eligible if HIV genotyping was successful. In most countries, people with HIV (PWH) with a recent infection, children with HIV younger than 18 months, and a country-specific selection of PWH with a nonrecent infection were included. In Nigeria and South Africa, PWH were eligible when viral load >200 or >1000 RNA copies/ml, respectively. HIV-1 variants were identified using the REGA HIV-1 & 2 Automated Subtyping Tool version 3.0. The estimated distributions of HIV-1 variants for each survey were calculated as the percentage distribution.

RESULTS: The sample size varied between 42 and 1434 PWH per country survey. Country distributions showed great variation, with a majority of CRF02_AG in Cameroon, Côte d'Ivoire and Nigeria; a majority of subtype A in Kenya, Rwanda, and Uganda; near equal proportions of subtype C (39%) and subtype A (37%) in Tanzania, and dominance of subtype C (>90%) in Ethiopia, Eswatini, Lesotho, Malawi, Namibia, South Africa, Zambia, and Zimbabwe. Recombinant viruses were mostly found in countries in West-Africa.

CONCLUSIONS: The distribution of HIV-1 variants by country and region in sub-Saharan Africa showed important variation. HIV-1 diversity may need to be accounted for during the development of HIV diagnostic and viral load tests, vaccines, other prevention interventions, and treatment.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
AIDS (London, England)
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:41704222
ISSN
1473-5571
DOI
10.1097/QAD.0000000000004471
language
English
LU publication?
yes
additional info
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.
id
e6f9464f-fd6c-487f-8287-e0c2a2351579
date added to LUP
2026-02-23 09:59:03
date last changed
2026-02-24 13:21:01
@article{e6f9464f-fd6c-487f-8287-e0c2a2351579,
  abstract     = {{<p>OBJECTIVE: To describe the distribution of HIV-1 variants in population-based national surveys conducted in sub-Saharan African countries between 2015 and 2022.</p><p>DESIGN: Multicountry analysis.</p><p>METHODS: Sixteen population-based national surveys, conducted between 2015 and 2022, were analyzed. Survey participants were eligible if HIV genotyping was successful. In most countries, people with HIV (PWH) with a recent infection, children with HIV younger than 18 months, and a country-specific selection of PWH with a nonrecent infection were included. In Nigeria and South Africa, PWH were eligible when viral load &gt;200 or &gt;1000 RNA copies/ml, respectively. HIV-1 variants were identified using the REGA HIV-1 &amp; 2 Automated Subtyping Tool version 3.0. The estimated distributions of HIV-1 variants for each survey were calculated as the percentage distribution.</p><p>RESULTS: The sample size varied between 42 and 1434 PWH per country survey. Country distributions showed great variation, with a majority of CRF02_AG in Cameroon, Côte d'Ivoire and Nigeria; a majority of subtype A in Kenya, Rwanda, and Uganda; near equal proportions of subtype C (39%) and subtype A (37%) in Tanzania, and dominance of subtype C (&gt;90%) in Ethiopia, Eswatini, Lesotho, Malawi, Namibia, South Africa, Zambia, and Zimbabwe. Recombinant viruses were mostly found in countries in West-Africa.</p><p>CONCLUSIONS: The distribution of HIV-1 variants by country and region in sub-Saharan Africa showed important variation. HIV-1 diversity may need to be accounted for during the development of HIV diagnostic and viral load tests, vaccines, other prevention interventions, and treatment.</p>}},
  author       = {{Ghys, Peter D and Voetsch, Andrew C and Justman, Jessica E and Patel, Hetal and Devos, Joshua R and Brown, Kristin and Ussery, Faith and Parekh, Bharat and Mahy, Mary and Abimiku, Alash'le and Aliyu, Sani and Aliyu, Gambo and Zuma, Khangelani and Moyo, Sizulu and van der Walt, Chéri and Kalimashe, Monalisa N and Ndongmo, Clement B and Kirungi, Wilford L and Arimide, Dawit A and Hemelaar, Joris}},
  issn         = {{1473-5571}},
  language     = {{eng}},
  month        = {{02}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{AIDS (London, England)}},
  title        = {{HIV-1 variants in population-based national surveys in sub-Saharan Africa, 2015-2022}},
  url          = {{http://dx.doi.org/10.1097/QAD.0000000000004471}},
  doi          = {{10.1097/QAD.0000000000004471}},
  year         = {{2026}},
}