Sallam Malik, Esbjörnsson Joakim, Baldvinsdóttir Guðrún, Indriðason Hlynur, Björnsdóttir Thora Björg, Widell Anders, Gottfreðsson Magnús, Löve Arthur, Medstrand Patrik
Lund University, Department of Translational Medicine, Malmö, Sweden.
University of Oxford, Nuffield Department of Medicine, Oxford, UK; Karolinska Institute, Microbiology, Tumor and Cell Biology, Stockholm, Sweden.
Infect Genet Evol. 2017 Apr;49:157-163. doi: 10.1016/j.meegid.2017.01.004. Epub 2017 Jan 7.
The molecular epidemiology of HIV-1 in Iceland has not been described so far. Detailed analyses of the dynamics of HIV-1 can give insights for prevention of virus spread. The objective of the current study was to characterize the genetic diversity and transmission dynamics of HIV-1 in Iceland. Partial HIV-1 pol (1020bp) sequences were generated from 230 Icelandic samples, representing 77% of all HIV-1 infected individuals reported in the country 1985-2012. Maximum likelihood phylogenies were reconstructed for subtype/CRF assignment and determination of transmission clusters. Timing and demographic growth patterns were determined in BEAST. HIV-1 infection in Iceland was dominated by subtype B (63%, n=145) followed by subtype C (10%, n=23), CRF01_AE (10%, n=22), sub-subtype A1 (7%, n=15) and CRF02_AG (7%, n=15). Trend analysis showed an increase in non-B subtypes/CRFs in Iceland over the study period (p=0.003). The highest proportion of phylogenetic clustering was found among injection drug users (IDUs; 89%), followed by heterosexuals (70%) and men who have sex with men (35%). The time to the most recent common ancestor of the oldest subtype B cluster dated back to 1978 (median estimate, 95% highest posterior density interval: 1974-1981) suggesting an early introduction of HIV-1 into Iceland. A previously reported increase in HIV-1 incidence among IDUs 2009-2011 was revealed to be due to two separate outbreaks. Our study showed that a variety of HIV-1 subtypes and CRFs were prevalent in Iceland 1985-2012, with subtype B being the dominant form both in terms of prevalence and domestic spread. The rapid increase of HIV-1 infections among IDUs following a major economic crisis in Iceland raises questions about casual associations between economic factors, drug use and public health.
冰岛HIV-1的分子流行病学至今尚未被描述。对HIV-1动态的详细分析可为预防病毒传播提供见解。本研究的目的是描述冰岛HIV-1的遗传多样性和传播动态。从230份冰岛样本中生成了部分HIV-1 pol（1020bp）序列，这些样本占该国1985 - 2012年报告的所有HIV-1感染者的77%。构建最大似然系统发育树以进行亚型/CRF分类和确定传播簇。在BEAST中确定时间和人口增长模式。冰岛的HIV-1感染以B亚型为主（63%，n = 145），其次是C亚型（10%，n = 23）、CRF01_AE（10%，n = 22）、A1亚亚型（7%，n = 15）和CRF02_AG（7%，n = 15）。趋势分析显示，在研究期间冰岛非B亚型/CRF的比例有所增加（p = 0.003）。在注射吸毒者（IDU；89%）中发现的系统发育聚类比例最高，其次是异性恋者（70%）和男男性行为者（35%）。最古老的B亚型簇的最近共同祖先时间可追溯到1978年（中位数估计，95%最高后验密度区间：1974 - 1981），这表明HIV-1早期传入冰岛。此前报道的2009 - 2011年IDU中HIV-1发病率增加被发现是由于两次独立的疫情爆发。我们的研究表明，1985 - 2012年冰岛流行多种HIV-1亚型和CRF，B亚型在流行率和国内传播方面均占主导地位。冰岛一场重大经济危机后IDU中HIV-1感染的迅速增加引发了关于经济因素、药物使用和公共卫生之间偶然关联的问题。
