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Global surveillance evidence

A 1.39-million-sample map of HIV-1 shows the diversity diagnostics and vaccines must keep pace with

The study assembled 1,395,222 HIV-1 subtype observations from 154 countries between 1990 and 2024 and weighted country estimates using UNAIDS numbers of people living with HIV. In 2020-24, subtype C represented 48.7% globally, followed by subtype A at 11.5% and subtype B at 10.3%. Unique and circulating recombinant forms were also substantial. Regional patterns differed sharply: subtype C dominated southern Africa and south Asia, CRF01_AE southeast Asia, and CRF07_BC increased in east Asia.

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Key findings

  • For 2020-24, subtype C was 48.7%, A 11.5%, B 10.3%, URFs 5.3%, CRF02_AG 5.1% and CRF01_AE 5.1%. Global proportions were broadly stable after 2000, but recombinants rose in western and central Europe and CRF07_BC in east Asia. Central Africa had the greatest diversity.
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Why this matters globally

The distribution matters for diagnostic and viral-load assays, resistance surveillance and vaccine design, whose performance may vary by variant. It also provides a benchmark for tracking changes associated with mobility, migration and treatment selection pressure.

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Thai researcher contribution

Dwip Kitayaporn of the HIV Netherlands Australia Thailand Research Collaboration is a coauthor, linking a Thailand-based network to the global map. The abstract does not separately report the Thai sample contribution.

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Limitations to consider

Countries and periods with stronger sequencing systems are better represented. Heterogeneous assays and sampling frames introduce inconsistency. UNAIDS weighting adjusts country scale but cannot remove within-country selection bias, and some regions remain sparsely observed.

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Verify the original sources

The Lancet Infectious DiseasesRead the original article

DOI: 10.1016/s1473-3099(26)00142-8

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