The Rakai Community Cohort Study in south central Uganda has surveyed people aged 15–49 since 1994. Antiretroviral therapy (ART) was introduced in 2004. HIV p24 and gp41 subtype distribution and viral diversity were studied from blood samples collected at three surveys in 1994–1995, 2002–2003, and 2008–2009, which were compared with a new survey round from 2011 to 2012. These included 1364 HIV+ individuals. For both p24 and gp41 domains, the genetic diversity within subtypes A and D was significantly increasing in the pre-ART era and decreased between the last two survey rounds in the ART era (p < .01). This study suggests that despite ongoing mixing of viral subtypes, an association with the introduction of ART to a reduction of intra-subtype viral genomic diversity may be occurring, which can be explored in ongoing studies.

中文翻译：

---

乌干达拉凯 18 年来的 HIV-1 亚型分布和多样性。

乌干达中南部的 Rakai 社区队列研究自 1994 年起对 15-49 岁的人群进行了调查。抗逆转录病毒治疗 (ART) 于 2004 年推出。通过 1994 年三项调查收集的血液样本研究了 HIV p24 和 gp41 亚型分布和病毒多样性。 1995 年、2002-2003 年和 2008-2009 年，与 2011 年至 2012 年的新一轮调查进行了比较。其中包括 1364 名 HIV+ 个体。对于 p24 和 gp41 结构域，亚型 A 和 D 内的遗传多样性在 ART 之前时代显着增加，而在 ART 时代的最后两轮调查之间下降（p < .01)。这项研究表明，尽管病毒亚型不断混合，但引入 ART 与亚型内病毒基因组多样性减少之间的关联可能正在发生，这可以在正在进行的研究中进行探索。