During the 1990s, HIV-1 spread rapidly through drug networks in Ukraine and from there throughout the former Soviet Union. To examine the origins of this epidemic, the genetics of HIV-1 in Ukraine were studied. Proviral DNA from PBMC was extracted and PCR amplified. Part of pol and nearly full genomes of HIV-1 were sequenced and characterized. The predominant genetic form in 163 strains was subtype A (66%), followed by subtypes B (30%), C (2%), D (1%), and a new AB recombinant form (1%). HIV strains from Kiev were diverse having subtypes A, B, C, and D. In Crimea, Donetsk, Poltava, and Odessa, however, the strains were overwhelmingly subtype A, while in Nikolaev subtype B predominated. After the near simultaneous introduction of subtypes A and B in Ukraine, subtype B remained where it was introduced while subtype A spread widely, creating the fastest growing epidemic in the world.

The vast majority of HIV-1 strains from the epidemic in the former Soviet Union (FSU) belong to subtype A (IDU-A) and CRF03_AB (IDU-A/B), for which IDU-A is one of parental strains; no epidemic by another parental virus, belonging to subtype B (IDU-B), has yet been identified. To characterize viruses present during the early stage of the epidemic in southern Ukraine, where the first outbreaks in the FSU were registered, we obtained partial env and pol sequences from IDUs from Odessa and Nikolaev and compared them with viruses from other outbreaks. All viruses from Odessa belonged to the IDU-A type, which is in accord with previous studies. At the same time, we found that the outbreak in Nikolaev was caused by IDU-B viruses, indicating that this outbreak is the result of an independent virus introduction. Phylogenetic analysis of viruses from the FSU supported the epidemiological data suggesting that the HIV-1 epidemic in the FSU started in southern Ukraine.

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