Abstract
Our aim was to investigate the dispersal patterns and parameters associated with local molecular transmission clusters (MTCs) of subtypes A1 and B in Greece (predominant HIV-1 subtypes). The analysis focused on 1751 (28.4%) and 2575 (41.8%) sequences of subtype A1 and B, respectively. Identification of MTCs was based on phylogenetic analysis. The analyses identified 38 MTCs including 2–1518 subtype A1 sequences and 168 MTCs in the range of 2–218 subtype B sequences. The proportion of sequences within MTCs was 93.8% (1642/1751) and 77.0% (1982/2575) for subtype A1 and B, respectively. Transmissions within MTCs for subtype A1 were associated with risk group (Men having Sex with Men vs. heterosexuals, OR = 5.34, p < 0.001) and Greek origin (Greek vs. non-Greek origin, OR = 6.05, p < 0.001) and for subtype B, they were associated with Greek origin (Greek vs. non-Greek origin, OR = 1.57, p = 0.019), younger age (OR = 0.96, p < 0.001), and more recent sampling (time period: 2011–2015 vs. 1999–2005, OR = 3.83, p < 0.001). Our findings about the patterns of across and within country dispersal as well as the parameters associated with transmission within MTCs provide a framework for the application of the study of molecular clusters for HIV prevention.
Highlights
HIV remains a major health challenge to date
We investigated the patterns of HIV-1 transmission across and among different geographic areas, and we estimated the parameters associated with regional transmission for the two most prevalent subtypes in Greece
We found that a high proportion of subtypes A1 and B, which are the predominant clades, occur locally at 93.8% and 77.0%, respectively
Summary
HIV remains a major health challenge to date. HIV transmissions have declined over the last few years, incidence remains high (http://www.UNAIDS.org). According to the UNAIDS/WHO, 1.7 million people became newly infected with HIV in 2019 (http://www.UNAIDS.org). HIV-1 genetic diversity is a hallmark of the virus and since the beginning of the epidemic, group M of HIV-1 has been genetically classified into pure subtypes (A–D, F–H, J–L), sub-subtypes, recombinant forms, and unclassified viruses [1,2]. The prevalence of HIV-1 subtypes and recombinants varies greatly with the subtype C being predominant, followed by subtypes B, A, CRF02_AG, and CRF01_AE [3]. In the absence of an effective vaccine and cure, prevention of HIV-1 transmission provides the only strategy to mitigate its impact and reduce incidence (http://www.UNAIDS.org)
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