Université de Normandie, Normandy, France.
Clin Microbiol Rev. 2013 Jul;26(3):448-61. doi: 10.1128/CMR.00012-13.
The AIDS pandemic that started in the early 1980s is due to human immunodeficiency virus type 1 (HIV-1) group M (HIV-M), but apart from this major group, many divergent variants have been described (HIV-1 groups N, O, and P and HIV-2). The four HIV-1 groups arose from independent cross-species transmission of the simian immunodeficiency viruses (SIVs) SIVcpz, infecting chimpanzees, and SIVgor, infecting gorillas. This, together with human adaptation, accounts for their genomic, phylogenetic, and virological specificities. Nevertheless, the natural course of non-M HIV infection seems similar to that of HIV-M. The virological monitoring of infected patients is now possible with commercial kits, but their therapeutic management remains complex. All non-M variants were principally described for patients linked to Cameroon, where HIV-O accounts for 1% of all HIV infections; only 15 cases of HIV-N infection and 2 HIV-P infections have been reported. Despite improvements in our knowledge, many fascinating questions remain concerning the origin, genetic evolution, and slow spread of these variants. Other variants may already exist or may arise in the future, calling for close surveillance. This review provides a comprehensive, up-to-date summary of the current knowledge on these pathogens, including the historical background of their discovery; the latest advances in the comprehension of their origin and spread; and clinical, therapeutic, and laboratory aspects that may be useful for the management and the treatment of patients infected with these divergent viruses.
艾滋病大流行始于 20 世纪 80 年代初，由人类免疫缺陷病毒 1 型（HIV-1）M 组（HIV-M）引起，但除了这个主要组之外，还描述了许多不同的变体（HIV-1 组 N、O 和 P 以及 HIV-2）。这四种 HIV-1 组是由感染黑猩猩的猿猴免疫缺陷病毒（SIV）SIVcpz 和感染大猩猩的 SIVgor 的物种间交叉传播而独立产生的。这与人类的适应一起解释了它们的基因组、系统发育和病毒学特征。然而，非-M HIV 感染的自然病程似乎与 HIV-M 相似。现在可以使用商业试剂盒对感染患者进行病毒学监测，但治疗管理仍然很复杂。所有非-M 变体主要是在与喀麦隆有关的患者中描述的，在那里 HIV-O 占所有 HIV 感染的 1%；仅报告了 15 例 HIV-N 感染和 2 例 HIV-P 感染。尽管我们的知识有所提高，但这些变体的起源、遗传进化和缓慢传播仍存在许多令人着迷的问题。其他变体可能已经存在或将来可能出现，需要密切监测。这篇综述全面、最新地总结了这些病原体的现有知识，包括它们发现的历史背景；对其起源和传播的最新理解进展；以及对管理和治疗感染这些不同病毒的患者可能有用的临床、治疗和实验室方面。
