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HIV-1 epidemic in Warao Amerindians from Venezuela: spatial phylodynamics and epidemiological patterns

Villalba, Julian A.a,b,*; Bello, Gonzaloc; Maes, Mailisd; Sulbaran, Yoneira F.e; Garzaro, Domingoe; Loureiro, Carmen L.e; Rangel, Hector R.e; de Waard, Jacobus H.d; Pujol, Flor H.e

doi: 10.1097/QAD.0b013e3283601bdb
Epidemiology and Social

Objectives: We previously reported HIV-1 infection in Warao Amerindians from Venezuela. The aim of this study was to evaluate the extent and the dynamic of HIV-1 dissemination in eight Warao communities.

Design and Setting: HIV-1 infection was evaluated in 576 Warao Amerindians from the Orinoco Delta. Partial HIV-1 pol sequences were analyzed to reconstruct the spatiotemporal and demographic dynamics of the epidemic.

Results: HIV-1 antibodies were present in 9.55% of Warao Amerindians, ranging from 0 to 22%. A significantly higher prevalence was found in men (15.6%) compared with women (2.6%), reaching up to 35% in men from one community. All but one isolates were classified as subtype B. Warao's HIV-1 subtype-B epidemic resulted from a single viral introduction at around the early 2000s. After an initial phase of slow growth, the subtype B started to spread at a fast rate (0.8/year) following two major routes of migration within the communities.

Conclusion: A dramatic high prevalence was documented in almost all the communities of Warao Amerindians from the Orinoco Delta tested for HIV-1 infection. This epidemic resulted from the dissemination of a single HIV-1 subtype B founder strain introduced about 10 years ago and its size is probably doubling every year, creating a situation that can be devastating for this vulnerable Amerindian group.

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aDirección Regional de Salud Estado Delta Amacuro, Tucupita, Venezuela

bLovelace Respiratory Research Institute, Albuquerque, New Mexico, USA

cLaboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz – FIOCRUZ, Rio de Janeiro, Brazil

dLaboratorio de Tuberculosis, Instituto de Biomedicina

eLaboratorio de Virología Molecular, Instituto Venezolano de Investigaciones Científicas Caracas, Venezuela.

*Lovelace Respiratory Research Institute, Albuquerque, USA.

Correspondence to Dr Flor H. Pujol, Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Científicas, Apdo 20632, Caracas 1020-A, Venezuela. Tel: +58 212 5041623; fax: +58 212 5041623; e-mail:

Received 2 December, 2012

Revised 31 January, 2013

Accepted 12 February, 2013

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© 2013 Lippincott Williams & Wilkins, Inc.