Kostaki Evangelia, Magiorkinis Gkikas, Psichogiou Mina, Flampouris Andreas, Iliopoulos Panos, Papachristou Eleni, Daikos Georgios L, Bonovas Stefanos, Otelea Dan, Friedman Samuel R, Hatzakis Angelos, Paraskevis Dimitrios
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
First Department of Medicine, Laiko GH, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Curr HIV Res. 2017;15(6):396-404. doi: 10.2174/1570162X15666171120104048.
New diagnoses of HIV-1 infection among people who inject drugs (PWID) increased significantly during 2011 in Athens.
Our aim was to investigate the patterns of HIV epidemic spread among PWID and to estimate the transmission dynamics for the major local transmission networks (LTNs).
We analyzed sequences from 2,274 HIV-infected subjects sampled in Greece during 01/01/2011-31/10/2014. Of specimens in our sample, 874 sequences were isolated from HIV-infected PWID. Phylodynamic analysis was performed using birth-death serial skyline models.
Phylogenetic analysis revealed that the majority of sequences from PWID (N=746, 85.4%) fell within four LTNs: CRF14_BG (N=456, 58.3%), CRF35_AD (N=149, 19.1%), subtype B (N=118, 15.1%) and A1 (N=59, 7.5%). In addition to PWID, we also found that sequences from 36 non-PWID belonged to the LTNs corresponding to cross-group transmissions. Based on the estimated plots of the effective reproductive number (Re) over time, subtype A1 and CRF35_AD LTNs showed a sharp increase before and during 2011 (maximum value of Re=3.0 and Re=4.6, respectively). For subtype B and CRF14_BG LTNs, the Re was increasing until the end of 2012 (maximum value of Re=3.2 and Re=3.0, respectively).
HIV transmissions within subtype A1 and CRF35_AD LTNs increased sharply during the early stage of the outbreak, in contrast to subtype B and CRF14_BG. A significant reduction in the number of infections was estimated on all transmission networks from the beginning of 2013 onwards. Prevention measures that took place in the Athens metropolitan area at the end of 2012 including also the ARISTOTLE program may explain this decrease.
2011年期间,雅典注射吸毒者(PWID)中新增的HIV-1感染诊断显著增加。
我们的目的是调查PWID中HIV流行传播模式,并估计主要本地传播网络(LTN)的传播动态。
我们分析了2011年1月1日至2014年10月31日期间在希腊采集的2274名HIV感染受试者的序列。在我们的样本中,874个序列是从HIV感染的PWID中分离出来的。使用出生-死亡序列天际线模型进行系统动力学分析。
系统发育分析显示,大多数来自PWID的序列(N = 746,85.4%)属于四个LTN:CRF14_BG(N = 456,58.3%)、CRF35_AD(N = 149,19.1%)、B亚型(N = 118,15.1%)和A1(N = 59,7.5%)。除PWID外,我们还发现36名非PWID的序列属于对应跨组传播的LTN。根据有效繁殖数(Re)随时间的估计图,A1亚型和CRF35_AD LTN在2011年之前和期间显示出急剧增加(Re的最大值分别为3.0和4.6)。对于B亚型和CRF14_BG LTN,Re一直增加到2012年底(Re的最大值分别为3.2和3.0)。
与B亚型和CRF14_BG相比,A1亚型和CRF35_AD LTN内的HIV传播在疫情爆发早期急剧增加。估计从2013年初起,所有传播网络中的感染数量都有显著减少。2012年底在雅典大都市区采取的预防措施,包括亚里士多德项目,可能解释了这种下降。