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In this study, the genetic diversity of HIV-1 in Tunisia was analyzed. For this, 193 samples were collected in different regions of Tunisia between 2012 and 2015. A protease and reverse transcriptase fragment were amplified and sequenced. Phylogenetic analyses were performed through maximum likelihood and recombination was analyzed by bootscanning. Six HIV-1 subtypes (B, A1, G, D, C, and F2), 5 circulating recombinant forms (CRF02_AG, CRF25_cpx, CRF43_02G, CRF06_cpx, and CRF19_cpx), and 11 unique recombinant forms were identified. Subtype B (46.4%) and CRF02_AG (39.4%) were the predominant genetic forms. A group of 44 CRF02_AG sequences formed a distinct Tunisian cluster, which also included four viruses from western Europe. Nine viruses were closely related to isolates collected in other African or in European countries. In conclusion, a high HIV-1 genetic diversity is observed in Tunisia and the local spread of CRF02_AG is first documented in this country.

Aim: To determine the prevalence of antibodies to hepatitis C virus (HCV) in a cohort of patients infected with human immunodeficiency virus 1 (HIV-1) and to compare risk factors., Methods: Multicenter retrospective study from infectious diseases department in Tunisia. We examined sera from HIV patients followed in these centers. Diagnosis of HCV infection was based on third generation enzyme-linked immunosorbent assay (ELISA) test., Results: 362 HIV-1 patients were included in the study. The mean age was 35,5 years. 272 patients (75.13%) were male. Sexual transmission of HIV was the main risk factor (56.3%). 144 patients (39.7%) had antibodies against HCV, mainly in patients with history of intravenous drug abuse (78.4%). Quantitative evaluation of hepatitis C virus RNA was done only in 3 patients., Conclusion: HCV-HIV coinfection in tunisian patients occurs frequently, due to the same ways of transmission. More studies are needed to focus on sexual transmission of hepatitis C virus in order to prevent such infections rather than interferon-based therapies.

A 35 year-old heterosexual man had a six months history of cervical myelitis with progressive paraplegia, leg weakness and paresthesia of the four extremities. Spinal cord MRI showed a high T2 signal intramedullary lesion wide from the bulbo-medullary junction to D4. Post gadolinium T1 sequence revealed an enhancement in front of C3-C4 vertebrae. VIH serology was positive. Corticosteroid treatment achieved a marked improvement. In addition to vacuolar myelopathy, well-known at the advanced stages of the HIV infection (AIDS), myelitis and clinical pictures simulating multiple sclerosis were described during early stages of the infection. These inflammatory lesions of the central nervous system and sometimes of the peripheral nervous system seems to be related to the immune response dysfunction induced by the VIH.