Bridging epidemiology with population genetics in a low incidence MSM-driven HIV-1 subtype B epidemic in Central Europe

Lunar, Maja M.; Vandamme, Anne‐Mieke; Tomažič, Janez; Karner, Primož; Vovko, Tomaž; Pečavar, Blaž; Volčanšek, Gabriele; Poljak, Mario; Abecasis, Ana

doi:10.1186/s12879-015-0802-6

Cited by 10 publications

(10 citation statements)

References 31 publications

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“…Similar findings were observed in Slovenia, where Lunar et al . determined a high percentage of clustering among Slovenian sequences (81%) 30 . Our findings are comparable with epidemiological studies from other Western and Central European countries, where HIV-1 infection is concentrated among MSM infected with subtype B, however the proportion of clustered sequences was <60% 25–28,45,46 .…”

Section: Discussionmentioning

confidence: 96%

“…Due to the previously reported high TDR prevalence in Croatia and the fact that there is a predominant epidemic occurring among MSM at the local level, in this study we characterized HIV transmission and drug resistance dynamics, geographic distribution and evolutionary origin of TC in Croatia by the use of phylogenetic and phylodynamic analysis 23–30 . We included >90% of treatment-naive patients who entered clinical care during a 4-year period, 2014–2017.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of HIV-1 diversity, primary drug resistance and transmission networks in Croatia

Oroz

Begovać

Planinić

et al. 2019

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Molecular epidemiology of HIV-1 infection in treatment-naive HIV-1 infected persons from Croatia was investigated. We included 403 persons, representing 92.4% of all HIV-positive individuals entering clinical care in Croatia in 2014–2017. Overall prevalence of transmitted drug resistance (TDR) was estimated at 16.4%. Resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside RTI (NNRTIs) and protease inhibitors (PIs) was found in 11.4%, 6.7% and 2.5% of persons, respectively. Triple-class resistance was determined in 2.2% of individuals. In addition, a single case (1.0%) of resistance to integrase strand-transfer inhibitors (InSTIs) was found. Deep sequencing was performed on 48 randomly selected samples and detected additional TDR mutations in 6 cases. Phylogenetic inference showed that 347/403 sequences (86.1%) were part of transmission clusters and identified forward transmission of resistance in Croatia, even that of triple-class resistance. The largest TDR cluster of 53 persons with T215S was estimated to originate in the year 1992. Our data show a continuing need for pre-treatment HIV resistance testing in Croatia. Even though a low prevalence of resistance to InSTI was observed, surveillance of TDR to InSTI should be continued.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Analysis of HIV-1 diversity, primary drug resistance and transmission networks in Croatia

Oroz

Begovać

Planinić

et al. 2019

Sci Rep

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“…Previous analysis of the dynamics of the subtype B epidemic in Slovenia, performed on a dataset obtained from patients diagnosed from 2000 to 2012, revealed eight large Slovenian clusters with ≥ 10 sequences and less than 20% of sequences without a transmission link to another Slovenian sequence. Only one pair of foreign sequences was nested within one large Slovenian cluster; otherwise, clusters encompassed only Slovenian sequences [ 24 ]. In contrast, this analysis included additional sequences from 2013 to 2016 and showed more intermixing of nationalities within large clusters because half of large clusters harbored sequences sampled abroad.…”

Section: Discussionmentioning

confidence: 99%

HIV-1 transmitted drug resistance in Slovenia and its impact on predicted treatment effectiveness: 2011–2016 update

et al. 2018

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HIV-positive individuals that have a detected transmitted drug resistance (TDR) at baseline have a higher risk of virological failure with antiretroviral therapy (ART). This study offers an update on the prevalence of TDR in Slovenia, looks for onward transmission of TDR, and reassesses the need for baseline drug resistance testing. Blinded questionnaires and partial pol sequences were obtained from 54.5% (168/308) of all of the patients diagnosed with HIV-1 from 2011 to 2016. Subtype B was detected in 82.7% (139/168) of patients, followed by subtype A (8.3%), subtype C (2.4%), and CRF01_AE (1.8%). Surveillance drug resistance mutations (SDRMs) were found in four individuals (2.4%), all of them men who have sex with men (MSM) and infected with subtype B. K103N was detected in two patients and T68D and T215D in one person each, corresponding to a prevalence of 0%, 1.2%, and 1.2% of TDR to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), and non-NRTIs (NNRTIs), respectively. The impact of mutations on drug susceptibility was found to be most pronounced for NNRTIs. No forward spread of TDR within the country was observed; however, phylogenetic analysis revealed several new introductions of HIV into Slovenia in recent years, possibly due to increased risky behavior by MSM. This was indirectly confirmed by a substantial increase in syphilis cases and HIV-1 non-B subtypes during the study period. A drug-resistant HIV variant with good transmission fitness is thus more likely to be imported into Slovenia in the near future, and so TDR should be closely monitored.

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“…Dated phylogenies of large transmission clusters (those containing at least 10 patients from the CV 46 ) were obtained with BEAST v1.8.1 47 , similarly as in Patiño-Galindo et al . 25 .…”

Section: Methodsmentioning

confidence: 99%

The molecular epidemiology of HIV-1 in the Comunidad Valenciana (Spain): analysis of transmission clusters

Patiño-Galindo

Torres-Puente

Bracho

et al. 2017

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HIV infections are still a very serious concern for public heath worldwide. We have applied molecular evolution methods to study the HIV-1 epidemics in the Comunidad Valenciana (CV, Spain) from a public health surveillance perspective. For this, we analysed 1804 HIV-1 sequences comprising protease and reverse transcriptase (PR/RT) coding regions, sampled between 2004 and 2014. These sequences were subtyped and subjected to phylogenetic analyses in order to detect transmission clusters. In addition, univariate and multinomial comparisons were performed to detect epidemiological differences between HIV-1 subtypes, and risk groups. The HIV epidemic in the CV is dominated by subtype B infections among local men who have sex with men (MSM). 270 transmission clusters were identified (>57% of the dataset), 12 of which included ≥10 patients; 11 of subtype B (9 affecting MSMs) and one (n = 21) of CRF14, affecting predominately intravenous drug users (IDUs). Dated phylogenies revealed these large clusters to have originated from the mid-80s to the early 00 s. Subtype B is more likely to form transmission clusters than non-B variants and MSMs to cluster than other risk groups. Multinomial analyses revealed an association between non-B variants, which are not established in the local population yet, and different foreign groups.

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Bridging epidemiology with population genetics in a low incidence MSM-driven HIV-1 subtype B epidemic in Central Europe

Cited by 10 publications

References 31 publications

Analysis of HIV-1 diversity, primary drug resistance and transmission networks in Croatia

Analysis of HIV-1 diversity, primary drug resistance and transmission networks in Croatia

HIV-1 transmitted drug resistance in Slovenia and its impact on predicted treatment effectiveness: 2011–2016 update

The molecular epidemiology of HIV-1 in the Comunidad Valenciana (Spain): analysis of transmission clusters

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