TY - JOUR
T1 - Molecular epidemiological analysis of the origin and transmission dynamics of the hiv-1 crf01_ae sub-epidemic in Bulgaria
AU - Alexiev, Ivailo
AU - Campbell, Ellsworth M.
AU - Knyazev, Sergey
AU - Pan, Yi
AU - Grigorova, Lyubomira
AU - Dimitrova, Reneta
AU - Partsuneva, Aleksandra
AU - Gancheva, Anna
AU - Kostadinova, Asya
AU - Seguin-Devaux, Carole
AU - Elenkov, Ivaylo
AU - Yancheva, Nina
AU - Switzer, William M.
N1 - Funding Information:
Funding: This work was supported in part by a grant from the Ministry of Education and Science, Bulgaria (contract: DN03/2-16.12.2016); by the National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria; by the National Program for the Prevention and Control of HIV and Sexually Transmitted Infections, Bulgaria; by the European Regional Development Fund through Operational Program Science and Education for Smart Growth 2014–2020, Grant BG05M2OP001-1.002-0001-C04 “Fundamental Translational and Clinical Investigations on Infections and Immunity”.
Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/1/16
Y1 - 2021/1/16
N2 - 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.
AB - 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.
KW - Circulat-ing recombinant forms
KW - Drug resistance
KW - HIV-1
KW - Molecular epidemiology
KW - Prevention
KW - Transmission clusters
KW - Transmission dynamics
UR - http://www.scopus.com/inward/record.url?scp=85100324565&partnerID=8YFLogxK
UR - https://www.ncbi.nlm.nih.gov/pubmed/33467166
U2 - 10.3390/v13010116
DO - 10.3390/v13010116
M3 - Article
C2 - 33467166
AN - SCOPUS:85100324565
SN - 1999-4915
VL - 13
JO - Viruses
JF - Viruses
IS - 1
M1 - 116
ER -