학술논문
Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions
Document Type
article
Author
Evangelia-Georgia Kostaki; Andreas Flampouris; Timokratis Karamitros; Natalia Chueca; Marta Alvarez; Paz Casas; Belen Alejos; Angelos Hatzakis; Federico Garcia; Dimitrios Paraskevis; CoRIS; Santiago Moreno; Inma Jarrín; David Dalmau; Maria Luisa Navarro; Maria Isabel González; Jose Luis Blanco; Rafael Rubio; Jose Antonio Iribarren; Félix Gutiérrez; Francesc Vidal; Juan Berenguer; Juan González; Belén Alejos; Victoria Hernando; Cristina Moreno; Carlos Iniesta; Luis Miguel Garcia Sousa; Nieves Sanz Perez; M Ángeles Muñoz-Fernández; Isabel María García-Merino; Irene Consuegra Fernández; Coral Gómez Rico; Jorge Gallego de la Fuente; Paula Palau Concejo; Joaquín Portilla; Esperanza Merino; Sergio Reus; Vicente Boix; Livia Giner; Carmen Gadea; Irene Portilla; María Pampliega; Marcos Díez; Juan Carlos Rodríguez; José Sánchez-Payá; Juan Luis Gómez; Jehovana Hernández; María Remedios Alemán; María del Mar Alonso; María Inmaculada Hernández; Felicitas Díaz-Flores; Dácil García; Ricardo Pelazas; Ana López Lirola; José Sanz Moreno; Alberto Arranz Caso; Cristina Hernández Gutiérrez; María Novella Mena; Federico Pulido; Otilia Bisbal; Asunción Hernando; Lourdes Domínguez; David Rial Crestelo; Laura Bermejo; Mireia Santacreu; José Antonio Iribarren; Julio Arrizabalaga; María José Aramburu; Xabier Camino; Francisco Rodríguez-Arrondo; Miguel Ángel von Wichmann; Lidia Pascual Tomé; Miguel Ángel Goenaga; Ma Jesús Bustinduy; Harkaitz Azkune; Maialen Ibarguren; Aitziber Lizardi; Xabier Kortajarena; Mar Masiá; Sergio Padilla; Andrés Navarro; Fernando Montolio; Catalina Robledano; Joan Gregori Colomé; Araceli Adsuar; Rafael Pascual; Marta Fernández; Elena García; José Alberto García; Xavier Barber; Juan Carlos López Bernaldo de Quirós; Isabel Gutiérrez; Margarita Ramírez; Belén Padilla; Paloma Gijón; Teresa Aldamiz-Echevarría; Francisco Tejerina; Francisco José Parras; Pascual Balsalobre; Cristina Diez; Leire Pérez Latorre; Joaquín Peraire; Consuelo Viladés; Sergio Veloso; Montserrat Vargas; Miguel López-Dupla; Montserrat Olona; Anna Rull; Esther Rodríguez-Gallego; Verónica Alba; Marta Montero Alonso; José López Aldeguer; Marino Blanes Juliá; María Tasias Pitarch; Iván Castro Hernández; Eva Calabuig Muñoz; Sandra Cuéllar Tovar; Miguel Salavert Lletí; Juan Fernández Navarro; Jose Miguel Molina; Juan González-garcia; Francisco Arnalich; José Ramón Arribas; Jose Ignacio Bernardino de la Serna; Juan Miguel Castro; Luis Escosa; Pedro Herranz; Victor Hontañón; Silvia García-Bujalance; Milagros García López-Hortelano; Alicia González-Baeza; Maria Luz Martín-Carbonero; Mario Mayoral; Maria Jose Mellado; Rafael Esteban Micán; Rocio Montejano; María Luisa Montes; Victoria Moreno; Ignacio Pérez-Valero; Berta Rodés; Talia Sainz; Elena Sendagorta; Natalia Stella Alcáriz; Eulalia Valencia; José Ramón Blanco; José Antonio Oteo; Valvanera Ibarra; Luis Metola; Mercedes Sanz; Laura Pérez-Martínez; Angels Jaén; Montse Sanmartí; Mireia Cairó; Javier Martinez-Lacasa; Pablo Velli; Roser Font; Mariona Xercavins; Noemí Alonso; Jesús Repáraz; María Gracia Ruiz de Alda; María Teresa de León Cano; Beatriz Pierola Ruiz de Galarreta; Ignacio de los Santos; Jesús Sanz Sanz; Ana Salas Aparicio; Cristina Sarriá Cepeda; Lucio Garcia-Fraile Fraile; Enrique Martín Gayo; José Luis Casado; Fernando Dronda; Ana Moreno; María Jesús Pérez Elías; Cristina Gómez Ayerbe; Carolina Gutiérrez; Nadia Madrid; Santos del Campo Terrón; Paloma Martí; Uxua Ansa; Sergio Serrano; María Jesús Vivancos; Enrique Bernal; Alfredo Cano; Antonia Alcaraz García; Joaquín Bravo Urbieta; Ángeles Muñoz; Maria Jose Alcaraz; Maria del Carmen Villalba; Federico García; José Hernández; Alejandro Peña; Leopoldo Muñoz; David Vinuesa; Clara Martinez-Montes; Fernando García; Carlos Guerrero-Beltran; Jorge Del Romero; Carmen Rodríguez; Teresa Puerta; Juan Carlos Carrió; Mar Vera; Juan Ballesteros; Oskar Ayerdi; Antonio Antela; Elena Losada; Antonio Aguilera; Melchor Riera; María Peñaranda; María Leyes; Ma Angels Ribas; Antoni A Campins; Carmen Vidal; Francisco Fanjul; Javier Murillas; Francisco Homar; Jesús Santos; Crisitina Gómez Ayerbe; Isabel Viciana; Rosario Palacios; Carmen María González; Pompeyo Viciana; Nuria Espinosa; Luis Fernando López-Cortés; Daniel Podzamczer; Elena Ferrer; Arkaitz Imaz; Juan Tiraboschi; Ana Silva; María Saumoy; Julián Olalla; Alfonso del Arco; Javier de la torre; José Luis Prada; José María García de Lomas Guerrero; Javier Pérez Stachowski; Concepción Amador; Onofre Juan Martínez; Francisco Jesús Vera; Lorena Martínez; Josefina García; Begoña Alcaraz; Amaya Jimeno; Angeles Castro Iglesias; Berta Pernas Souto; Alvaro Mena de Cea; Carlos Galera; Helena Albendin; Aurora Pérez; Asunción Iborra; Antonio Moreno; Maria Angustias Merlos; Asunción Vidal; Inés Suárez-García; Eduardo Malmierca; Patricia González-Ruano; Dolores Martín Rodrigo; Mohamed Omar Mohamed-Balghata; Juan A Pineda; Juan Macías; Miguel Thomson; Elena Delgado; Sonia Benito; Vanessa Montero
Source
Frontiers in Microbiology, Vol 10 (2019)
Subject
Language
English
ISSN
1664-302X
Abstract
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 2–79 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 (tMRCA) 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.