The Emergence of HIV/AIDS in the Americas and Beyond

Gilbert MTP, Rambaut A, Wlasiuk G, Spira TJ, Pitchenik AE & Worobey M

(2007) Proc Natl Acad Sci USA 104, 18566-18570.

HIV-1 group M subtype B was the first human immunodeficiency virus discovered and is the predominant variant of AIDS virus in most countries outside of sub-Saharan Africa. However, the circumstances of its origin and emergence remain unresolved. Here we propose a geographic sequence and timeline for the origin of subtype B and the emergence of pandemic HIV/AIDS out of Africa. Using HIV-1 gene sequences recovered from archival samples from some of the earliest known Haitian AIDS patients, we find that subtype B likely moved from Africa to Haiti in or around 1966 [1962-1970] then spread there for some years before successfully dispersing elsewhere. A ?pandemic? clade, encompassing the vast majority of non-Haitian subtype B infections in the US and elsewhere around the world, subsequently emerged after a single migration of the virus out of Haiti in or around 1969 [1966-1972]. Haiti appears to have the oldest HIV/AIDS epidemic outside sub-Saharan Africa and the most genetically diverse subtype B epidemic, which might present challenges for HIV-1 vaccine design and testing. The emergence of the pandemic variant of subtype B was an important turning point in the history of AIDS but its spread was likely driven by ecological rather than evolutionary factors. Our results suggest that HIV-1 circulated cryptically in the US for approximately twelve years before the recognition of AIDS in 1981.

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Andrew Rambaut, 2007