Papathanasopoulos Maria A, Hunt Gillian M, Tiemessen Caroline T
AIDS Virus Research Unit, National Institute for Communicable Diseases, Department of Virology, University of the Witwatersrand, Johannesburg, South Africa.
Virus Genes. 2003;26(2):151-63. doi: 10.1023/a:1023435429841.
The HIV/AIDS pandemic represents a major development crisis for the African continent, which is the worst affected region in the world. Currently, almost 30 of the 42 million people infected with HIV worldwide live in Africa. AIDS in humans is caused by two lentiviruses, HIV-1 and HIV-2, which entered the human population by zoonotic transmissions from at least two different African primate species. Extensive phylogenetic analyses of partial and full-length genome sequences have helped to gain insights into the evolutionary biology and population dynamics of HIV. One of the major characteristics of HIV is its rapid evolution, which has resulted in substantial genetic diversity amongst different isolates, the majority of which are represented in Africa. Genetic variability of HIV and any consequent phenotypic variation poses a significant challenge to disease control and surveillance in different geographic regions of Africa. This review focuses on the origins and evolution of HIV, current classification and diversity of HIV isolates in Africa and provides an extensive account of the geographic distribution of HIV types, groups, and subtypes in each of the 49 African countries. Numerous epidemiological studies have provided a picture of HIV distribution patterns in most countries in Africa, and these show increasing evidence of the importance of HIV-1 recombinants. In particular, this review highlights that our current understanding of HIV distribution in Africa is incomplete and inadequately represents the diversity of the virus, and underscores the need for ongoing surveillance.
艾滋病毒/艾滋病大流行是非洲大陆面临的重大发展危机，非洲是世界上受影响最严重的地区。目前，全球4200万艾滋病毒感染者中近3000万人生活在非洲。人类艾滋病由两种慢病毒，即艾滋病毒1型和艾滋病毒2型引起，它们通过人畜共患病传播从至少两种不同的非洲灵长类物种进入人类群体。对部分和全长基因组序列进行的广泛系统发育分析有助于深入了解艾滋病毒的进化生物学和种群动态。艾滋病毒的主要特征之一是其快速进化，这导致不同分离株之间存在大量遗传多样性，其中大多数存在于非洲。艾滋病毒的遗传变异性以及由此产生的任何表型变异对非洲不同地理区域的疾病控制和监测构成了重大挑战。本综述重点关注艾滋病毒的起源和进化、非洲艾滋病毒分离株的当前分类和多样性，并详细介绍了49个非洲国家中每个国家艾滋病毒类型、组和亚型的地理分布。众多流行病学研究描绘了非洲大多数国家的艾滋病毒分布模式，这些研究越来越多地表明艾滋病毒1型重组体的重要性。特别是，本综述强调我们目前对非洲艾滋病毒分布的理解并不完整，未能充分体现该病毒的多样性，并强调了持续监测的必要性。
