Biological and Socio-Medical Studies to Establish Anti-AIDS/HIV Strategies in Sub-Saharan Countries, Especially Zambia

HIV-1感染在撒哈拉以南非洲大陆最为普遍。为了从病毒学和社会医学的角度调查这些地区的艾滋病/艾滋病毒，我们进行了几项研究：首先，我们从位于南部非洲的赞比亚卢萨卡的感染者中分离出许多HIV-1株。分析了病毒的基因型和表型。结果表明，该地区流行的病毒主要为C亚型，其中66%的病毒在LTR中含有3个NF-κ B结合位点。后一个事实至少可以部分解释为什么这种类型的HIV-1在赞比亚比其他类型的HIV-1传播得更快。然后，我们能够首次建立几个感染性C亚型克隆。由于进化枝C是最主要和最重要的HIV-1亚型，我们的疫苗策略应该集中在这一类型中。本研究获得的HIV-1感染性C分支克隆将为开发临床可用的艾滋病疫苗提供强有力的分子工具。假设在不久的将来，包括赞比亚在内的撒哈拉以南非洲国家显然难以单独利用技术、人力和财力克服这些障碍。因此，期望这些国家有效利用包括世卫组织和艾滋病规划署在内的国际捐助者的财政支助，改革和增强其卫生和医疗战略。另一方面，我们外国捐助者应该在捐助者内部和与赞比亚政府分享信息，并参与决策活动，为这一地方和全球问题做出贡献。

HIV-1 infection is most prevalent in sub-Saharan African continent. To investigate AIDS/HIV in these area from the virological as well as socio-medical aspects, we have carried out several studies.First, we isolated many HIV-1 strains from the infected individuals in Lusaka, Zambia located in southern Africa. The viruses were analysed for genotypes and phenotypes. We showed that viruses prevalent in these area were predominantly subtype C, and 66% of them contained 3 NF-kB binding sites in the LTR. The latter fact may explain at least partially the reason why this type of HIV-1 is disseminated over the other types in Zambia. We then were able to establish several infectious subtype C clones for the first time. Since clade C is the most predominant and important HIV-1 subtype, our vaccine strategy should focus on this type among others. Infectious clade C HIV-1 clones obtained in the present studies will be a powerful molecular tool to develop clinically available AIDS vaccines.Assuming the AIDS/HIV problems in the near future, it is apparently difficult for the sub-Saharan countries including Zambia to clear these hurdles with their own capacities alone utilizing power for technology, man and finance. Thus, it is expected for these countries to efficiently exploit the financial support from international donors including WHO and UNAIDS in reforming and empowering their health and medical strategies. On the other hand, we foreign donors should share information within donors and with the Zambian government, and participate in decision making events to contribute to this local and global matter.