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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
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.
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