Molecular Epidemiological Analysis of the Origin and Transmission Dynamics of the HIV-1 CRF01_AE Sub-Epidemic in Bulgaria

Alexiev, Ivailo and Campbell, Ellsworth M. and Knyazev, Sergey and Pan, Yi and Grigorova, Lyubomira and Dimitrova, Reneta and Partsuneva, Aleksandra and Gancheva, Anna and Kostadinova, Asya and Seguin-Devaux, Carole and Elenkov, Ivaylo and Yancheva, Nina and Switzer, William M. (2021) Molecular Epidemiological Analysis of the Origin and Transmission Dynamics of the HIV-1 CRF01_AE Sub-Epidemic in Bulgaria. Viruses, 13 (1). p. 116. ISSN 1999-4915

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Abstract

HIV-1 subtype CRF01_AE is the second most predominant strain in Bulgaria, yet little is known about the molecular epidemiology of its origin and transmissibility. We used a phylodynamics approach to better understand this sub-epidemic by analyzing 270 HIV-1 polymerase (pol) sequences collected from persons diagnosed with HIV/AIDS between 1995 and 2019. Using network analyses at a 1.5% genetic distance threshold (d), we found a large 154-member outbreak cluster composed mostly of persons who inject drugs (PWID) that were predominantly men. At d = 0.5%, which was used to identify more recent transmission, the large cluster dissociated into three clusters of 18, 12, and 7 members, respectively, five dyads, and 107 singletons. Phylogenetic analysis of the Bulgarian sequences with publicly available global sequences showed that CRF01_AE likely originated from multiple Asian countries, with Vietnam as the likely source of the outbreak cluster between 1988 and 1990. Our findings indicate that CRF01_AE was introduced into Bulgaria multiple times since 1988, and infections then rapidly spread among PWID locally with bridging to other risk groups and countries. CRF01_AE continues to spread in Bulgaria as evidenced by the more recent large clusters identified at d = 0.5%, highlighting the importance of public health prevention efforts in the PWID communities.

Item Type: Article
Uncontrolled Keywords: HIV-1; molecular epidemiology; transmission clusters; transmission dynamics; circulating recombinant forms; drug resistance; prevention
Subjects: e-Archives > Medical Science
Depositing User: Managing Editor
Date Deposited: 12 Nov 2022 07:54
Last Modified: 07 May 2024 05:07
URI: http://ebooks.abclibraries.com/id/eprint/142

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