HIV-positive immigrants in the Canary Islands, Spain:: Implications for public health in Europe

Background: The Canary Islands face the northwest coast of Africa and belong administratively to Spain. They represent a frequent step for the entrance of Africans into Spain and, from there, to all the European Union. The presence of HIV-1 non-B variants has already been reported in Spain and other European countries, mostly among African immigrants. Purpose: The aim of this study was to exam the genetic diversity of HIV-1 among immigrants attending a reference hospital in the Canary Islands during 2000. Method: Phylogenetic analyses of the reverse transcriptase (RT), protease, and env genes were carried out in 33 immigrants found to be HIV-1 positive. Results: HIV-1 non-B subtypes were recognized in 21 (63.6%) of the 33 infected participants. Phylogenetic analyses showed non-B sequences in 60%, 60.6%, and 48.3% of specimens, depending on the genomic region examined (PT, protease, and env, respectively). Overall, 15 viruses (45%) were found to be inter-subtype recombinants: AG in 8 (53%), GB in 4 (27%), and AB in 3 (20%). Conclusion: Nearly two thirds of HIV-infected immigrants arriving to the Canary Islands carry non-B subtypes. Thus, the Canary Islands may be a frequent entry point for new HIV-1 variants into the European Union.