The Origins of a Concentrated HIV-1 Epidemic in Pakistan
نویسندگان
چکیده
Data on the subtypes of HIV in a population help in predicting the potential foci of epidemic, tracking the routes of infection and following the patterns of the virus’ genetic divergence. Globally, the most prevalent HIV infection is the HIV-1 subtype C. In Asia, predominant subtypes of HIV-1 are B, C, and CRF-01AE. During the last few years, HIV prevalence in Pakistan has taken the form of a concentrated epidemic in at least two high risk groups, namely, Intravenous Drug Users (IDUs) and Male Sex Workers. Factors that have facilitated the proliferation of HIV infection include transmission through a large number of repatriates and needle-sharing intravenous drug users, unscreened blood transfusions, and sexual illiteracy. The HIV subtypes infecting Pakistani populations have not been explored to date. In this study, we analyzed HIV-1 subtypes from in a high-risk community of IDUs in Karachi, the largest city of Pakistan. Subtyping was performed using subtype-specific nested polymerase chain reaction (PCR), as well as Heteroduplex Mobility Assay (HMA). Only HIV-1 subtype A was found in the 34 samples analyzed. Two of the individuals studied were previously employed in the United Arab Emirates, where they admitted to have sexual contact with commercial sex workers. The two subjects became IDUs after returning to Pakistan, following deportation by the UAE government as a result of their HIV infection status. The evidence we present here indicates that the route of transmission of HIV subtype A into the Pakistani population may have been through repatriates from countries in Emirates. The results of our study underscore the necessity for implementing immigration policies for screening and counseling the travelers frequenting Pakistani borders.
منابع مشابه
HIV/AIDS in Pakistan
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