The Evolution Of HIV Assignment Discussion Paper
The World Health Organization (WHO) study shows that HIV-1 denoted as Human Immunodeficiency Virus, is the most serious world healthcare challenge, with approximately 38 million individuals being affected. Wei, Duffy, and Allison, (2018) reveal that different viruses and strains of this infectious disease with recurrent conditions occur in most parts of Europe and middle Asia. Ramusuran, (2019) denotes that in Europe, Subtype C of HIV -1 is most predominant, with a 46% overall rate. The HIV 1 Subtype C has risen to be the dominant type in many European countries and is virulent more than other strains. The HIV-1 Subtype C is common in countries of Europe such as; Luxembourg, Monaco, Netherlands, France, Austria, and Liechtenstein. The evolution of the Subtype C virus is dependent on genetic variations between virus subtypes among the infected populations in Europe (Von, Boni and Shah et al., 2011). The increasing cases of HIV-1 are a result of the regeneration of high and risky populations in periods of socio-political and economic changes in most parts of Europe.
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Notably, the HIV-1 Subtype C comprises a larger population than other strains and variants. The prevalence of this strain is due to the phenotypic variations between Subtype C and different viral strains permitting increased infection rates in the continent (Sen, Kaminski and Kurachi et al., 2016). This strain’s transmission, pathogenicity, and efficiency depend on socio-demographic trends in various parts of the continent. Bimewies, Roberts and Kerstenetai et al., (2018) assert that it is significant to analyze how Subtype C eliminates other variants in this continent. To understand the evolutionary aspects of escalating Subtype C infection rate in the continent, there is a need to evaluate the mechanisms of this variant pathogenesis to less dominant variants considering the phenotypic and genetic characteristics (Sen,Kaminski and Kurachi et al., 2016)The Evolution Of HIV Assignment Discussion Paper.
HIV-1 virus is categorized into four main parts, namely: Main (M), Outlier (O), Non-M (N), and group P viruses. Zanini, Brodin and Thebo et al., (2015) assert that these groups evolve from the independent transmission of cross-species occurrence in human beings and Non-Human Primates (NHP). This research article will significantly dwell on group M. This group contains ten subtysubtypes of equal importance and measure: A, B, C, D, E, F, G, H, I, J, and K (Ramusuran, 2019). There are also numerous circulating recombinant forms (CRFs) with diversity sequences ranging from 20 to 35% depending on the genetic region evaluated and subtypes categorized. The HIV-1 Subtype C is primarily predominant in low-income areas of Eastern Europe, Southern Africa, Ethiopia, and Eastern Africa. These regions commonly bear the burdens and effects of HIV-1 Subtype C, with most adults affected hence affecting marriages among couples.
Objectives
Fig.1; The HIV structure (Spivak and Planelles 2018)
Most phylogenic data reveal that Group M of HIV -1 originated from Kinshasa in the Democratic Republic of Congo from 1909 to 1930. Taylor, McCutchman, and Hammar et al., (2020) assert that the evolution of this strain of Group M has been predominant in most parts of the world. The originality of Subtype C HIV was in Mbuji-Mayi, a city in the DRC. The dense population of this city escalated the spread of this variant globally since most immigrants from neighboring countries work in these diamond mines. This signifies that this city was a central high-risk area for spreading HIV variants globally. Tokarev, Sivro and Omole et al., (2020) reveal that original strains of HIV-1 were introduced to neighboring countries such as Kenya, Uganda, Zimbabwe, and Namibia by the workers coming from DRC diamond mines. This evolution of this disease coincided with timelines of the socio-political changes within South Africa. Vercauteren, Wensing and Balotta et al, (2009) asserts that this Migration in and out of South Africa established to increase trade and commerce escalated the infection rates of HIV-1 due to high fertility rates, facilitating the exponential growth of the Subtype C variant in the late 1980s and mid-1990s. Most studies reveal that the socio-demographic patterns of Southern Africa influenced the prevalence of HIV-1 in those regions, with South Africa mostly affected.
Fig3. The HIV-1 Replication cycle (Ramusuran 2019)The Evolution Of HIV Assignment Discussion Paper
This article significantly analyses and evaluates the efficiency of replication, pathogenesis mechanisms, and efficiency of disease progression and transmission in understanding the escalating expansion of this variant more than others in the continent (Sen, Kaminski and Kurachi et al 2016). Phylogenetic data reveals that Southern Africa has more viral load than any other country, with 98% of most infections caused by Subtype C. However, the Subtype C is increasing in most parts of Europe hence being a primary global health concern (Spivak and Planelles, 2018). This research paper focuses on Subtype C, which is increasingly predominant within Europe with significant concerns on married couples in middle and low-income areas.
Figure 2: Evolution of HIV-1 Subtype C Prevalence (McBrien, Kumar and Silvestri et al. 2018)
The application of Molecular epidemiology is the most efficient tool for establishing sensitive diagnostic procedures for managing individual infections through evaluating transmission patterns, and the evolution of the variants (Parken, Sammons and Maze et al., 2016). Molecular epidemiology study in Europe is at the early stages of development and has not contributed to establishing policy and programs.
Hypothesis
Recent analysis and evaluation of the epidemiology of Subtype C in Europe reveal the rising prevalence of this variant among the population. Sen Kaminskiand Kurachi et al., (2016) reveals that the spread of this variant is slowly increasing among the middle and low-income people in the continent. Countries such as Norway, Denmark, Sweden, Greece, and France had increased prevalence rates of this variant more than other counterparts in Europe (Tokarev, Sivro and Omole et al., 2020). However, the escalating epidemic rate in risky populations consists of injecting drug users (IDU), and female commercial sex workers in these countries, males having sexual intercourse with males (MSM). HIV-1 Exposures between individuals linked to traveling abroad also prompt the spread of this strain pattern on the continent.
The major objective of this research project is to evaluate the evolution of HIV-1 Subtype C in Europe from the years 1995-to 2000 and 2019-to 2021. The following are the study sub-objective:
- To evaluate and analyze the growth and development of HIV-1 Subtype C in Europe.
- To analyze, evaluate the variation of different strains of HIV-1
- To analyze the transmission rate of Subtype C strain in various countries on the continent.
This research aims to evaluate and review the increase of the HIV-1 Subtype C in Europe, with significant emphasis being between 1995-2000 and 2019-to 2021(McBrien, Kumar and Silvestri et al., 2018). This research paper considers and analyzes the prevalence and prevailing rates of HIV-1 Subtype C variant infections. Notably, it reviews the existential evidence of the HIV -1 pattern in these periods and understands the transmission patterns in the continent.
This research is a component of a systematic review of data patterns complimented by an established significant focus on the published HIV-1 Subtype C molecular epidemiology p-published literature in Europe. The research entailed most countries in Europe with most focus on the middle and low-income populations. Parrish, Gao and Zajic et al., (2013) denote that due to the geographical similarity and proximity in the continent and the demographic trends of population patterns of the socio-cultural context, the study included the Middle East and Egypt.
Patient: The significant source of data information in this research was the European Epidemiology Synthesis Project, which was obligated to harness data on sexually transmitted infections (STI), HIV, and sexually transmitted diseases in Europe. Major investigations were conducted through the spread programs from September 1995 to 2000 and from to 2019-2021 for the transmitted drug-resistant (TDR) project (Huang, Postow and Manne et al., 2017). This research was conducted in all countries with 2576 patients with newly diagnosed infection of HIV-1 Subtype C being interviewed (Colby et al., 2018). The observable importance the of SPREAD program is to analyze and evaluate the TDR in European countries. This enabled the study of temporal patterns and assessed the possible predictors for TDR.
Research Methods
Kaslow, Tang and Dorak et al., denote that in conducting interviews, the overall prevalence TDR rate was 10.2% (300 of 2576 patients; 94% confidence interval (C.I) 7.6% -9.7% interval), frequency of nucleoside reverse- transcriptase inhibitor (NRTI) resistance was 5.7% (204 of 2576 patient; 96% CI, 4.1 % – 5.2 %), the prevalence of no nucleoside reverse-transcriptase inhibitor (NNRTI) resistance was 4%. Of the 101 of 2576 patients, 93% C.I., 3.4 %-5.4%, protein inhibitor (P.I.) resistance was 2.9% (Hui, Cheung and Taylor et al., 2017). The overall TDR, NRTI, and NNRTI resistance were not in the time trend of the research study; however, statistically, there was a reduction in P.I. resistance (p =.03) and a significant increase in NNRTI resistance after initial resistance (p=.05)The Evolution Of HIV Assignment Discussion Paper.
The study recognized the stabilization of TDR in Europe is consistent with decreased resistance to drugs hence high viral suppression of HIV-1 Subtype C individuals. Bennet, Otelea and Feury et al., 2009 assert that, despite the successful treatment of HIV-1, a few groups of patients have failed in treatment and adherence procedures and are at high risk of spreading this variant in the continent.
Methods: Behavioral, clinical, and epidemiological data were collected through standardized questionnaires and phylogenetic analysis. Leyre, Kroon and Colby et al., (2020) state that the phylogenetic analysis is significant in evaluating and analyzing the HIV-1 transmission networks. It effectively evaluates transmitted drug resistance cases and public health transmission initiatives. This procedure involves the application of standardized characterization of laboratory tests using probability and quality assurance tests (Joseph, Swanstrom and Kashuba et al., 2015). The main objective of phylogenetic analysis is to evaluate the evolutionary forms of HIV-1 Subtype C in Europe. Three methods of phylogenetic analysis are; distance, maximum parsimony, and maximum likelihood.
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Markowitz, Mendo and Gotuzzo et al., (2007) state that the three modes of phylogenetic analysis are commonly used in analyzing evolutionary trees conforming to the evolution trends of HIV-1 Subtype C in Europe through observation of variation of group sequences. These methods require different standardized applications while researching HIV-1. Microbiology programs and laboratory tests commonly apply the distance method due to its reliability and efficiency (Margolis, Garcia and Hazuda et al., 2016). The reliability of the distance procedure enables the application of an extensive sequence of tests or units within short periods. The maximum likelihood methods are always challenging since they require a deep understanding of evolutionary trends of infections in various geographical locations. Dufour, Gantner and Fromentin et al., (2021) asseassertt maximum likelihood methods require many computational procedures dramatically due to the rapid increase of sequencing of multiple variants The Evolution Of HIV Assignment Discussion Paper