Emerg Infect DiseidEmerging Infectious Diseases1080-60401080-6059Centers for Disease Control98667442640249Research ArticleIntroduction of HIV-2 and multiple HIV-1 subtypes to Lebanon.PieniazekD.dxp1@cdc.govBaggsJ.HuD. J.MatarG. M.AbdelnoorA. M.MokhbatJ. E.UwaydahM.BizriA. R.RamosA.JaniniL. M.TanuriA.FridlundC.SchableC.HeyndrickxL.RayfieldM. A.HeneineW.HIV/Retrovirus Diseases Branch, Division of AIDS, STD, and TB Laboratory Research, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.Oct-Dec199844649656

HIV genetic variability, phylogenetic relationships, and transmission dynamics were analyzed in 26 HIV-infected patients from Lebanon. Twenty-five specimens were identified as HIV-1 and one as HIV-2 subtype B. The 25 strains were classified into six env-C2-V3 HIV-1 subtypes: B (n = 10), A (n = 11), C (n = 1), D (n = 1), G (n = 1), and unclassifiable. Potential recombinants combining parts of viral regions from different subtypes Aenv/Dpol/Agag, Genv/Apol, and the unclassifiable-subtype(env)/unclassifiable-subtype(pol)/Agag were found in three patients. Epidemiologic analysis of travel histories and behavioral risks indicated that HIV-1 and HIV-2 subtypes reflected HIV strains prevalent in countries visited by patients or their sex partners. Spread of complex HIV-subtype distribution patterns to regions where HIV is not endemic may be more common than previously thought. Blood screening for both HIV-1 and HIV-2 in Lebanon is recommended to protect the blood supply. HIV subtype data provide information for vaccine development.