To study the dynamics of HIV genetic forms and variants of resistance to antiretroviral therapy.
CNAIDS is committed to identifying the different genetic variants of HIV circulating in the geographical areas endemic to infection, determining their frequency, evaluating the association of these variants with antiretroviral drug resistance and determining their dynamics in the population. These are fundamental data to implement public health interventions in order to prevent the spread of HIV infection and optimize antiretroviral therapy in the global fight against HIV/AIDS.
HIV includes subtypes and circulating recombinant forms (CRF). The distribution of these genetic forms is geographically characterized, but it evolves continuously as a result of population movements due to war or poverty, or business or leisure travel. Sub-Saharan Africa is the "hub" of these genetic variants.
In Southern Sudan, little data is available on the circulation of HIV strains due to 40 years of civil war. CNAIDS has, therefore, launched a study for the characterization of genetic forms of HIV in this region. The data highlighted the appearance of different genetic forms of the virus due to population movements across the borders of Sudan during the civil war. Hence the importance of a continuous surveillance of the dynamics of these genetic forms in this country.
The study will be expanded to include South Africa, characterized by large population movements due to migratory phenomena or due to mobility for work. In particular, the study will use biological samples collected as part of the observational clinical studies conducted in situ by CNAIDS on 500 HIV-positive people, naïve for ART and ART-treated, who live in a trans-frontier area frequented by people with high risk behaviors for HIV infection (e.g. prostitutes and their clients, such as mining and seasonal workers). These samples will be used to characterize circulating HIV strains and assess the presence of viral variants including those of resistant to antiretroviral therapy, both in ART naïve and ART-treated patients.