{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T06:15:25Z","timestamp":1794032125679,"version":"4.8.0"},"reference-count":138,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["mBio"],"published-print":{"date-parts":[[2025,10,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Human immunodeficiency virus type 1 (HIV-1) group M comprises 10 genetically diverse subtypes, with subtypes C and B being the most prevalent globally. However, rare subtypes F, H, J, K, and L, though individually responsible for less than 1% of HIV-1 infections worldwide, play relevant roles in viral evolution, global persistence, recombination, and drug resistance. This review provides a comprehensive synthesis of the available literature on these rare subtypes for the first time, emphasizing their distribution, recombination patterns, transmission dynamics, and drug resistance-associated mutations. A key observation is that many of these rare subtypes are more frequently found in recombinant forms than in non-recombinant forms, which may expand their geographic distribution and sustain their epidemiological presence. We further highlight drug resistance-associated mutations in the protease and reverse transcriptase regions of the rare subtypes, which may affect treatment outcomes. Advances in molecular tools, such as next-generation sequencing and Bayesian phylogeographic analyses, have improved the identification of the rare subtypes in both recombinant and non-recombinant forms. However, there remains a significant data gap in the clinical impact of these subtypes as they continue to be undersampled and understudied. This review thus underscores the need for augmenting subtype-specific surveillance strategies, especially in regions where the rare subtypes predominantly circulate. Expanding research on these rare subtypes will be essential for understanding HIV-1 recombination and evolutionary dynamics, identifying trends in drug resistance, and developing more globally inclusive anti-viral strategies that better reflect the diversity of HIV-1.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/mbio.01264-25","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T13:00:20Z","timestamp":1755781220000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["Rare but relevant: a comprehensive narrative review of rare HIV-1 group M subtypes"],"prefix":"10.1128","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6809-8783","authenticated-orcid":true,"given":"Dana F.","family":"Indihar","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05hz8m414","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biological Sciences, Alabama A&M University","place":["Huntsville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Oke","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05hz8m414","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biological Sciences, Alabama A&M University","place":["Huntsville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rondel","family":"Hemerding","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05hz8m414","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biological Sciences, Alabama A&M University","place":["Huntsville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De'Travean","family":"Williams","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05hz8m414","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biological Sciences, Alabama A&M University","place":["Huntsville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupert","family":"England","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05hz8m414","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biological Sciences, Alabama A&M University","place":["Huntsville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laricca Y.","family":"London","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05hz8m414","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biological Sciences, Alabama A&M University","place":["Huntsville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a006841"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2001.0863"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2010.0031"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.288.5463.55d"},{"key":"e_1_3_1_6_2","unstructured":"Los Alamos National Laboratory Sequence Database. n.d. 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