Abstract
The human immunodeficiency virus-type 1 (HIV-1) subtype B has probably been circulating on the island of Hispaniola since the 1960s, but information about the early viral history on this Caribbean island is scarce. In this study, we reconstruct the dissemination dynamics of early divergent non-pandemic subtype B lineages (designated BCAR) on Hispaniola by analyzing a country-balanced dataset of HIV-1 BCAR pol sequences from Haiti (n = 103) and the Dominican Republic (n = 123). Phylogenetic analyses supported that BCAR strains from Haiti and the Dominican Republic were highly intermixed between each other, although the null hypothesis of completely random mixing was rejected. Bayesian phylogeographic analyses placed the ancestral BCAR virus in Haiti and the Dominican Republic with the same posterior probability support. These analyses estimate frequent viral transmissions between Haiti and the Dominican Republic since the early 1970s onwards, and the presence of local BCAR transmission networks in both countries before first AIDS cases was officially recognized. Demographic reconstructions point that the BCAR epidemic in Hispaniola grew exponentially until the 1990s. These findings support that the HIV-1 epidemics in Haiti and the Dominican Republic have been connected by a recurrent bidirectional viral flux since the initial phase, which poses a great challenge in tracing the geographic origin of the BCAR epidemic within Hispaniola using only genetic data. These data also reinforce the notion that prevention programs have successfully reduced the rate of new HIV-1 transmissions in Hispaniola since the end of the 1990s.
Highlights
The island of Hispaniola, shared by Haiti and the Dominican Republic, included in 2016 around 217,000 people living with the human immunodeficiency virus-type 1 (HIV-1), the etiologic agent of the acquired immunodeficiency syndrome (AIDS) (UNAIDS, 2013, 2017)
Analysis of the epidemiological characteristics of Haitian subjects showed that both BCAR and BPANDEMIC viral lineages circulated among males and females of different age groups (Supplementary Table S3)
This study confirms that the HIV-1 subtype B epidemic in Haiti is mostly driven by dissemination of early divergent non-pandemic BCAR lineages (Cabello et al, 2014)
Summary
The island of Hispaniola, shared by Haiti and the Dominican Republic, included in 2016 around 217,000 people living with the human immunodeficiency virus-type 1 (HIV-1), the etiologic agent of the acquired immunodeficiency syndrome (AIDS) (UNAIDS, 2013, 2017). AIDS cases recognized in Haiti (Pape et al, 1983) and the Dominican Republic (Koenig et al, 1987) mostly involved men who had sex with men, but these countries have generalized epidemics predominantly driven by heterosexual sex (Figueroa, 2008). The early dissemination dynamics of the HIV-1 subtype B epidemics between Haiti and the Dominican Republic remain largely unknown. Another study with a large number of HIV-1 sequences from the Dominican Republic has shown that subtype B virus circulates in this country since the early 1960s (Lopez et al, 2015), a result comparable to the estimated age of the Haitian epidemic. This study, may have traced the age of the Haitian subtype B ancestor rather than of the Dominican one, given that it assumed that all subtype B infections in the Dominican Republic resulted from a single introduction and that the hypothesis of multiple independent viral introductions from Haiti was not formally tested
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