Transmission dynamics of HIV-1 subtype B in the Basque Country, Spain
Por:
Patiño-Galindo JA, Thomson MM, Pérez-Álvarez L, Delgado E, Cuevas MT, Fernández-García A, Nájera R, Iribarren JA, Cilla G, López-Soria L, Lezaun MJ, Cisterna R, González-Candelas F and Group of HIV-1 Antiretroviral Resistance Studies in the Basque Country
Publicada:
1 jun 2016
Ahead of Print:
26 feb 2016
Resumen:
This work was aimed to study the HIV-1 subtype B epidemics in the Basque Country, Spain. 1727HIV-1 subtype B sequences comprising protease and reverse transcriptase (PR/RT) coding regions, sampled between 2001 and 2008, were analyzed. 156 transmission clusters were detected by means of phylogenetic analyses. Most of them comprised less than 4 individuals and, in total, they included 441 patients. Six clusters comprised 10 or more patients and were further analyzed in order to study their origin and diversification. Four clusters included men who had unprotected homosexual sex (MSM), one group was formed by intravenous drug users (IDUs), and another included both IDUs and people infected through unprotected heterosexual sex (HTs). Most of these clusters originated from the mid-1980s to the mid-1990s. Only one cluster, formed by MSM, originated after 2000. The time between infections was significantly lower in MSM groups than in those containing IDUs (P-value <0.0001). Nucleoside RT and non-nucleoside RT inhibitor (NRTI and NNRTI)-resistance mutations to antiretroviral treatment were found in these six clusters except the most recent MSM group, but only the IDU clusters presented protease inhibitor (PI)-resistance mutations. The most prevalent mutations for each inhibitor class were PI L90M, NRTI T215D/Y/F, and NNRTI K103N, which were also among the most prevalent resistant variants in the whole dataset. In conclusion, while most infections occur as isolated introductions into the population, the number of infections found to be epidemiologically related within the Basque Country is significant. Public health control measures should be reinforced to prevent the further expansion of transmission clusters and resistant mutations occurring within them. (c) 2016 Elsevier B.V. All rights reserved.
Filiaciones:
:
Joint Research Unit "Infection and Public Health" FISABIO-Universitat de Valencia, Spain
CIBER in Epidemiology and Public Health, Madrid, Spain
Thomson MM:
Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
Pérez-Álvarez L:
Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
Delgado E:
Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
Cuevas MT:
Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
Fernández-García A:
Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
Nájera R:
Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
Iribarren JA:
Hospital Universitario Donostia, San Sebastián, Spain
Cilla G:
CIBER for Respiratory Diseases, Madrid, Spain
López-Soria L:
Hospital Universitario Cruces, Bilbao, Spain
Lezaun MJ:
Hospital Universitario Araba, Vitoria, Spain
Cisterna R:
Hospital Universitario Basurto, Bilbao, Spain
:
Joint Research Unit "Infection and Public Health" FISABIO-Universitat de Valencia, Spain
CIBER in Epidemiology and Public Health, Madrid, Spain.
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