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.

Author Information

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.