Research
HIV-1 subtype distribution and its demographic determinants in newly diagnosed patients in Europe suggest highly compartmentalized epidemics
1 Unidade de Saúde Pública Internacional e Bioestatística, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
2 Centro de Malária e Outras Doenças Tropicais, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
3 Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands
4 Department of Hygiene Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
5 Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
6 StatUa Center for Statistics, Universiteit Antwerpen, Antwerpen, Belgium
7 Department of Virology, Erasmus Medical Center, Rotterdam, the Netherlands
8 Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
9 Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
10 Section for Microbiology and Immunology, The Gade Institute, University of Bergen, Bergen, Norway
11 University of Milan, Milan, Italy
12 Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
13 Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
14 irsiCaixa AIDS Research Institute & Lluita contra la SIDA Foundation, Hospital Universitari "Germans Tria si Pujol", Badalona, Spain
15 University College Dublin, Dublin, Ireland
16 National Public Health Surveillance Laboratory, Vilnius, Lithuania
17 Sheba Medical Center, Ramat Gan, and Tel Aviv University, Tel Aviv, Israel
18 Robert-Koch Institute, Berlin, Germany
19 Warsaw Medical University and Hospital of Infectious Diseases, Warsaw, Poland
20 Infectology Center of Latvia, Riga, Latvia
21 Institut für Klinische und Molekulare Virologie, University of Erlangen-Nuremberg, Erlangen, Germany
22 University of Cyprus, Nicosia, Cyprus
23 National Institute for Health and Welfare, Helsinki, Finland
24 National Institute of Public Health, Prague, Czech Republic
25 Statens Serum Institute, Copenhagen, Denmark
26 Molecular Diagnostics, "Prof. Dr .Matei Bals" Institute for Infectious Diseases, Bucharest, Romania
27 University of Ljubljana, Ljubljana, Slovenia
28 Medical University Vienna, Vienna, Austria
29 Laboratory of Retrovirology, CRP-Santé, Luxembourg, Luxembourg
30 Centre Hospitalier de Luxembourg, Rollengergronn-Belair-Nord, Luxembourg
31 Divisions of Infectious Diseases and Clinical Virology, Karolinska Institute, Stockholm, Sweden
32 Slovak Medical University, Bratislava, Slovakia
33 University of Belgrade, School of Medicine, Belgrade, Serbia
Retrovirology 2013, 10:7 doi:10.1186/1742-4690-10-7
Published: 14 January 2013Abstract
Background
Understanding HIV-1 subtype distribution and epidemiology can assist preventive measures and clinical decisions. Sequence variation may affect antiviral drug resistance development, disease progression, evolutionary rates and transmission routes.
Results
We investigated the subtype distribution of HIV-1 in Europe and Israel in a representative sample of patients diagnosed between 2002 and 2005 and related it to the demographic data available. 2793 PRO-RT sequences were subtyped either with the REGA Subtyping tool or by a manual procedure that included phylogenetic tree and recombination analysis. The most prevalent subtypes/CRFs in our dataset were subtype B (66.1%), followed by sub-subtype A1 (6.9%), subtype C (6.8%) and CRF02_AG (4.7%). Substantial differences in the proportion of new diagnoses with distinct subtypes were found between European countries: the lowest proportion of subtype B was found in Israel (27.9%) and Portugal (39.2%), while the highest was observed in Poland (96.2%) and Slovenia (93.6%). Other subtypes were significantly more diagnosed in immigrant populations. Subtype B was significantly more diagnosed in men than in women and in MSM > IDUs > heterosexuals. Furthermore, the subtype distribution according to continent of origin of the patients suggests they acquired their infection there or in Europe from compatriots.
Conclusions
The association of subtype with demographic parameters suggests highly compartmentalized epidemics, determined by social and behavioural characteristics of the patients.
