Predominance of CCR5-dependent HIV-1 subtype E isolates in Cambodia.

The National AIDS Control and Prevention Program of the Cambodian ministry of health has reported that the prevalence of HIV-1 infection among blood donors in Cambodia increased from less than 1% in 1991 to 4% in 1996 and that 39.3% of prostitutes 7.1% of military personnel 3.2% of pregnant women and 5.2% of tuberculosis patients were infected in 1997. Findings are presented from an investigation of the genetic and biological features of HIV-1 strains in Cambodia. Viruses from 95 HIV-1-seropositive individuals were subtyped by heteroduplex mobility assay (HMA) and 23 were further analyzed for their biologic characteristics. 89 people were clearly infected with HIV-1 subtype E. The other 6 samples however were sequenced together with 17 HMA subtype E samples. All but 1 of these latter 23 Cambodian env sequences clustered with previously described Thai and Vietnamese subtype E sequences bearing a GPGQ motif at the tip of the V3 loop with the last having a GPGR motif and being phylogenetically equidistant from Asian and African subtype E viruses. Nonsyncytium-inducing CCR5-dependent viruses predominated in patients of clinical stage B and were detected in about half of the stage C patients. All syncytium-inducing strains mostly from AIDS patients used both CCR5 and CXCR4. The presence of syncytium-inducing viruses did not correlate with the plasma viral load. These data show that CCR5-dependent HIV-1 subtype E currently predominates in Cambodia. The dynamics of the viral population during subtype E infection in Southeast Asia appear to be similar to that of subtype B infection in Europe and the US.