An HIV Type 1 Subtype A Strain of Low Genetic Diversity Continues to Spread among Injecting Drug Users in Russia: Study of the New Local Outbreaks in Moscow and Irkutsk

Abstract

An explosive epidemic of human immunodeficiency virus type 1 (HIV-1) has been documented among injecting drug users (IDUs) in the former Soviet Union republics. In 1999, the two largest local IDU outbreaks of HIV-1 infection in the Russian Federation were registered in the Moscow and Irkutsk regions, where 13,004 HIV-1 cases were identified (44% of the total number of HIV-1 infections in Russia in 1999). To study the prevailing genetic variants and to estimate the genetic diversity of HIV-1 in these outbreaks, 60 samples from Moscow (n = 36) and from Irkutsk (n = 24) were analyzed using the gag/env heteroduplex mobility assay, and the env gp120 V3 encoding regions obtained from 23 individuals were sequenced. Both virus populations were highly homogeneous (the means of pairwise nucleotide distance were 1.75 +/- 0.83 and 2.35 +/- 1.59 for Irkutsk and Moscow, respectively), and similar to the subtype A viruses obtained earlier from IDUs in the former Soviet Union. The subtype A HIV-1 variant thus dominates in the largest HIV-1 outbreaks among IDUs in the Russian Federation.

The HIV Epidemic: High-Income Countries

“…A very large population of injection drug users adopting highly unsafe practices (Dehne et al 1999) was the focus of massive, explosive epidemics (Aceijas et al 2004). Virus obtained in 1995 from Donetsk in eastern Ukraine and Krasnodar in southern Russia, about 350 km distant, were very similar, with about 2% divergence in the C2-V3 region, and belonged to subtype A but had some unique features (Bobkov et al 1997) that allowed it to be easily tracked as it spread from Ukraine to St. Petersburg and Estonia in the 1990s and then in the 21st century, on to other parts of Russia, including Moscow and Irkutsk (Siberia) (Bobkov et al 2001), as well as neighbors, including Kazakhstan (Bobkov et al 2004) and the Baltic states (Zetterberg et al 2004). Soon after the original outbreak in Ukraine, there was an explosive outbreak in the Former Soviet Union enclave of Kaliningrad.…”

The HIV-1 Epidemic: Low- to Middle-Income Countries

“…There are multiple examples of founder effects, with subtype C being the most successful, globally having founded epidemics in South Africa, India, Ethiopia, and South America (Hermelaar et al 2006). Other founder effects are seen in Thailand, with subtype B IDU epidemic and CRF01_AE heterosexual epidemic (Korber et al 2000), in Russia and Eastern Europe with subtype A IDU epidemic (Bobkov et al 2001), and in China with CRF07_B 0 C IDU epidemic Piyasirisilp et al 2000;Su et al 2000;Tee et al 2008).…”

Comparing the Ex Vivo Fitness of CCR5-Tropic Human Immunodeficiency Virus Type 1 Isolates of Subtypes B and C

“…However, it should be noted that many of these temporal changes in subtype distribution might be due simply to founder events in different susceptible human populations. For example, subtype A, associated with heterosexual transmission in Africa, has recently emerged in Russia among intravenous drug users (7). This population is typically infected by subtype B in most of the developed world.…”