ABSTRACT
The HIV-1 epidemic in India is caused mainly by subtype C viruses that are transmitted sexually and by injecting drug use. The state of Tamil Nadu in Southern India has an HIV-1 median prevalence of 16.8% among injecting drug users, 6.6% in men who have sex with men, and 4.6% in female sex workers. In the rural district of Namakkal, a prevalence >3% was detected among antenatal women. The goal of this study was to determine the HIV-1 molecular epidemiology in Tamil Nadu. Blood samples were collected from 40 high-risk HIV-seropositive individuals from Chennai and Namakkal. HIV-1 subtype was determined by envelope nucleotide sequencing. Among the samples studied, 85% were subtype C, however, a cluster of subtype A samples (12.5%) and one subtype E recombinant form CRF01_AE (close to the Thailand strains) were detected. The average genetic distance of subtype C samples from Chennai and Namakkal were 9.44 ± 0.77% and 11.8 ± 0.7%, respectively indicating an evolved epidemic. This pilot study confirmed that subtype C was predominant in these regions but an outbreak of subtype A was detected in Namakkal. These results stress the importance of periodic monitoring of circulating HIV-1 subtypes in South India.
Subject(s)
Epidemics , HIV Infections/epidemiology , HIV Infections/virology , HIV-1/classification , HIV-1/genetics , Adolescent , Adult , Blood/virology , Cluster Analysis , Female , Genotype , HIV-1/isolation & purification , Humans , India/epidemiology , Male , Molecular Epidemiology , Phylogeny , Sequence Analysis, DNA , Sequence Homology , Young Adult , env Gene Products, Human Immunodeficiency Virus/geneticsABSTRACT
As antiretroviral therapy (ART) becomes more available to the HIV-infected population, it is important to determine the prevalence of its long-term complications. In this cross-sectional study, 145 HIV-positive patients on ART, 146 HIV-positive patients not on ART, and 72 HIV-negative individuals visiting the Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited from February 2007 to April 2009. Among the patients on ART, the prevalence of lipodystrophy was 60.7%; 22.7% with lipohypertrophy, 51.1% with lipoatrophy, and 22.7% with mixed pattern. The proportion of patients with dyslipidemia was significantly higher in the treatment group when compared to ART-naive and HIV-negative controls (P = .00). Total duration of ART was significantly associated with lipodystrophy (P = .04) and dyslipidemia (P = .01). Also, by logistic regression, abnormal metabolic levels were a risk factor in lipodystrophy (P = .02). This study highlights the need for development of inexpensive and accessible treatments for the reduction of lipodystrophy.
