Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

被引：13

作者：

Kostaki, Evangelia-Georgia ^{[1
]}

Flampouris, Andreas ^{[1
]}

Karamitros, Timokratis ^{[2
,3
]}

Chueca, Natalia ^{[4
,22
]}

Alvarez, Marta ^{[4
,22
]}

Casas, Paz ^{[4
,22
]}

Alejos, Belen ^{[5
]}

Hatzakis, Angelos ^{[1
]}

Garcia, Federico ^{[4
]}

Paraskevis, Dimitrios ^{[1
]}

Moreno, Santiago ^{[20
]}

Jarrin, Inma

Dalmau, David ^{[17
]}

Navarro, Maria Luisa

Gonzalez, Maria Isabel

Blanco, Jose Luis

Rubio, Rafael ^{[10
]}

Gutierrez, Felix ^{[12
]}

Vidal, Francesc ^{[13
]}

Berenguer, Juan ^{[6
]}

Gonzalez, Juan

Hernando, Victoria

Moreno, Cristina

Iniesta, Carlos

Sousa, Luis Miguel Garcia

Perez, Nieves Sanz

Angeles Munoz-Fernandez, M. ^{[6
]}

Maria Garcia-Merino, Isabel ^{[6
]}

Consuegra Fernandez, Irene ^{[6
]}

Gomez Rico, Coral ^{[6
]}

Gallego de la Fuente, Jorge ^{[6
]}

Palau Concejo, Paula ^{[6
]}

Portilla, Joaquin ^{[7
]}

Merino, Esperanza ^{[7
]}

Reus, Sergio ^{[7
]}

Boix, Vicente ^{[7
]}

Giner, Livia ^{[7
]}

Gadea, Carmen ^{[7
]}

Portilla, Irene ^{[7
]}

Pampliega, Maria ^{[7
]}

Diez, Marcos ^{[7
]}

Carlos Rodriguez, Juan ^{[7
]}

Sanchez-Paya, Jose ^{[7
]}

Luis Gomez, Juan ^{[8
]}

Hernandez, Jehovana ^{[8
]}

Remedios Aleman, Maria ^{[8
]}

del Mar Alonso, Maria ^{[8
]}

Inmaculada Hernandez, Maria ^{[8
]}

Diaz-Flores, Felicitas ^{[8
]}

Garcia, Dacil ^{[8
]}

机构：

[1] Natl & Kapodistrian Univ Athens, Med Sch, Dept Hyg Epidemiol & Med Stat, Athens, Greece

[2] Univ Oxford, Dept Zool, Oxford, England

[3] Hellenic Pasteur Inst, Dept Microbiol, Publ Hlth Labs, Athens, Greece

[4] Hosp Univ San Cecilio, Inst Invest Ibs, Dept Clin Microbiol, Granada, Spain

[5] Univ Alcale Henares, Ctr Nacl Epidemiol, Madrid, Spain

[6] Hosp Gen Univ Gregorio Maranon, Madrid, Spain

[7] Hosp Gen Univ Alicante, Alicante, Spain

[8] Hosp Univ Canarias, San Cristobal De La Lagu, Spain

[9] Hosp Univ Cent Asturias, Oviedo, Spain

[10] Hosp Univ 12 Octubre, Madrid, Spain

[11] Hosp Univ Donostia, Donostia San Sebastian, Spain

[12] Hosp Gen Univ De Elche, Elche, Spain

[13] Hosp Univ Tarragona Joan XXIII, Tarragona, Spain

[14] Hosp Univ & Politecn La Fe, Valencia, Spain

[15] Hosp Univ La Paz IdiPAZ, Madrid, Spain

[16] Hosp San Pedro, Ctr Invest Biomed La Rioja CIBIR, Logrono, Spain

[17] Hosp Univ MutuaTerrassa, Terrassa, Spain

[18] Complejo Hosp Navarra, Pamplona, Spain

[19] Hosp Univ La Princesa, Madrid, Spain

[20] Hosp Univ Ramon Y Cajal, Madrid, Spain

[21] Hosp Gen Univ Reina Sofia, Murcia, Spain

[22] Hosp Univ San Cecilio, Granada, Spain

[23] Ctr Sanitario Sandoval, Madrid, Spain

[24] Hosp Clin Univ Santiago, Santiago De Compostela, Spain

[25] Hosp Univ Son Espases, Palma De Mallorca, Spain

[26] Hosp Univ Virgen Victoria, Malaga, Spain

[27] Hosp Univ Virgen Rocio, Seville, Spain

[28] Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain

[29] Hosp Costa Sol, Marbella, Spain

[30] Hosp Marina Baixa, Alicante, Spain

[31] Hosp Gen Univ Santa Lucia, Cartagena, Spain

[32] Chuac, La Coruna, Spain

[33] Hosp Univ Virgen Arrixaca, El Palmar, Spain

[34] Hosp Univ Infanta Sofia, San Sebastian De Reyes, Spain

[35] Complejo Hosp Jaen, Jaen, Spain

[36] Nuestra Senora Valme, Seville, Spain

[37] ISCIII, Ctr Nacl Microbiol, Madrid, Spain

来源：

FRONTIERS IN MICROBIOLOGY | 2019年 / 10卷

关键词：

HIV-1; CRF02_AG; Spain; regional dispersal; spatiotemporal characteristics; INFECTED PATIENTS CORIS; NON-B SUBTYPES; MOLECULAR EPIDEMIOLOGY; SPANISH COHORT; SPREAD; MIGRATION;

D O I：

10.3389/fmicb.2019.00370

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41-6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain. Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000-2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively. Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p < 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 279 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (t(MRCA)) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999-2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin. Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics.

引用

页数：9

共 23 条

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