Jovanovic Luka, Siljic Marina, Cirkovic Valentina, Salemovic Dubravka, Jevtovic Djordje, Alexiev Ivailo, Zidovec-Lepej Snjezana, Oroz Maja, Begovac Josip, Paraskevis Dimitrios, Skoura Lemonia, Chaztidimitriou Dimitrios, Kostaki Evangelia G, Dragas Snezana, Dupanovic Brankica, Otelea Dan, Paraschiv Simona, Poljak Mario, Lunar Maja M, Stanojevic Maja
University of Belgrade Faculty of Medicine, Institute of Microbiology and Immunology.
Institute for Oncology and Radiology of Serbia.
AIDS. 2023 Jan 1;37(1):125-135. doi: 10.1097/QAD.0000000000003394. Epub 2022 Sep 19.
To analyze phylogenetic relations and assess the role of cross-border clusters in the spread of HIV-1 subtype B across the Balkans, given the general trends of new HIV diagnoses in seven Balkan countries.
Retrospective phylogenetic and trend analysis.
In-depth phylogenetic, phylodynamic and phylogeographic analysis performed on 2415 HIV-1 subtype B sequences from 1999 to 2019 using maximal likelihood and Bayesian methods. The joinpoint regression analysis of new HIV diagnoses by country and modes of transmission using 2004-2019 ECDC data.
Ninety-three HIV-1 Subtype B transmission clusters (68% of studied sequences) were detected of which four cross-border clusters (11% of studied sequences). Phylodynamic analysis showed activity of cross-border clusters up until the mid-2000s, with a subsequent stationary growth phase. Phylogeography analyses revealed reciprocal spread patterns between Serbia, Slovenia and Montenegro and several introductions to Romania from these countries and Croatia. The joinpoint analysis revealed a reduction in new HIV diagnoses in Romania, Greece and Slovenia, whereas an increase in Serbia, Bulgaria, Croatia and Montenegro, predominantly among MSM.
Differing trends of new HIV diagnoses in the Balkans mirror differences in preventive policies implemented in participating countries. Regional spread of HIV within the countries of former Yugoslavia has continued to play an important role even after country break-up, whereas the spread of subtype B through multiple introductions to Romania suggested the changing pattern of travel and migration linked to European integration of Balkan countries in the early 2000s.
鉴于巴尔干地区七个国家新的艾滋病毒诊断总体趋势，分析系统发育关系并评估跨境集群在HIV-1 B亚型在巴尔干地区传播中的作用。
回顾性系统发育和趋势分析。
使用最大似然法和贝叶斯方法，对1999年至2019年的2415条HIV-1 B亚型序列进行深入的系统发育、系统动力学和系统地理学分析。利用2004 - 2019年欧洲疾病预防控制中心（ECDC）的数据，对各国新的艾滋病毒诊断和传播方式进行连接点回归分析。
检测到93个HIV-1 B亚型传播集群（占研究序列的68%），其中4个跨境集群（占研究序列的11%）。系统动力学分析表明，跨境集群的活动一直持续到21世纪中叶，随后进入稳定增长阶段。系统地理学分析揭示了塞尔维亚、斯洛文尼亚和黑山之间的相互传播模式，以及这些国家和克罗地亚多次向罗马尼亚的传播。连接点分析显示，罗马尼亚、希腊和斯洛文尼亚新的艾滋病毒诊断有所减少，而塞尔维亚、保加利亚、克罗地亚和黑山则有所增加，主要是在男男性行为者中。
巴尔干地区新的艾滋病毒诊断趋势不同，反映了参与国实施的预防政策存在差异。即使在前南斯拉夫各国解体后，艾滋病毒在这些国家内部的区域传播仍继续发挥重要作用，而B亚型通过多次传入罗马尼亚表明，21世纪初与巴尔干国家欧洲一体化相关的旅行和移民模式发生了变化。
