Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions
Kostaki, E. G.; Flampouris, A.; Karamitros, T.; Chueca, N.; Alvarez, M.; Casas, P.; Alejos, B.; Hatzakis, A.; Garcia, F.; Paraskevis, D.; Moreno, S.; Jarrin, I.; Dalmau, D.; Navarro, M. L.; Gonzalez, M. I.; Blanco, J. L.; Rubio, R.; Iribarren, J. A.; Gutierrez, F.; Vidal, F.; Berenguer, J.; Gonzalez, J.; Hernando, V.; Moreno, C.; Iniesta, C.; Sousa, L. M. G.; Perez, N. S.; Munoz-Fernandez, M. A.; Garcia-Merino, I. M.; Fernandez, I. C.; Rico, C. G.; de la Fuente, J. G.; Concejo, P. P.; Portilla, J.; Merino, E.; Reus, S.; Boix, V.; Giner, L.; Gadea, C.; Portilla, I.; Pampliega, M.; Diez, M.; Rodriguez, J. C.; Sanchez-Paya, J.; Gomez, J. L.; Hernandez, J.; Aleman, M. R.; Alonso, M. D.; Hernandez, M. I.; Diaz-Flores, F.; Garcia, D.; Pelazas, R.; Lirola, A. L.; Moreno, J. S.; Caso, A. A.; Gutierrez, C. H.; Mena, M. N.; Pulido, F.; Bisbal, O.; Hernando, A.; Dominguez, L.; Crestelo, D. R.; Bermejo, L.; Santacreu, M.; Arrizabalaga, J.; Aramburu, M. J.; Camino, X.; Rodriguez-Arrondo, F.; von Wichmann, M. A.; Tome, L. P.; Goenaga, M. A.; Bustinduy, M. J.; Azkune, H.; Ibarguren, M.; Lizardi, A.; Kortajarena, X.; Masia, M.; Padilla, S.; Navarro, A.; Montolio, F.; Robledano, C.; Colome, J. G.; Adsuar, A.; Pascual, R.; Fernandez, M.; Garcia, E.; Garcia, J. A.; Barber, X.; de Quiros, Jclb; Gutierrez, I.; Ramirez, M.; Padilla, B.; Gijon, P.; Aldamiz-Echevarria, T.; Tejerina, F.; Parras, F. J.; Balsalobre, P.; Diez, C.; Latorre, L. P.; Peraire, J.; Vilades, C.; Veloso, S.; Vargas, M.; Lopez-Dupla, M.; Olona, M.; Rull, A.; Rodriguez-Gallego, E.; Alba, V.; Alonso, M. M.; Aldeguer, J. L.; Julia, M. B.; Pitarch, M. T.; Hernandez, I. C.; Munoz, E. C.; Tovar, S. C.; Lleti, M. S.; Navarro, J. F.; Molina, J. M.; Gonzalez-garcia, J.; Arnalich, F.; Arribas, J. R.; de la Serna, J. I. B.; Castro, J. M.; Escosa, L.; Herranz, P.; Hontanon, V.; Garcia-Bujalance, S.; Lopez-Hortelano, M. G.; Gonzalez-Baeza, A.; Martin-Carbonero, M. L.; Mayoral, M.; Mellado, M. J.; Mican, R. E.; Montejano, R.; Montes, M. L.; Moreno, V.; Perez-Valero, I.; Rodes, B.; Sainz, T.; Sendagorta, E.; Alcariz, N. S.; Valencia, E.; Blanco, J. R.; Oteo, J. A.; Ibarra, V.; Metola, L.; Sanz, M.; Perez-Martinez, L.; Jaen, A.; Sanmarti, M.; Cairo, M.; Martinez-Lacasa, J.; Velli, P.; Font, R.; Xercavins, M.; Alonso, N.; Rivero, M.; Reparaz, J.; de Alda, M. G. R.; Cano, M. T. D.; de Galarreta, B. P. R.; de los Santos, I.; Sanz, J. S.; Aparicio, A. S.; Cepeda, C. S.; Fraile, L. G. F.; Gayo, E. M.; Casado, J. L.; Dronda, F.; Moreno, A.; Elias, M. J. P.; Ayerbe, C. G.; Gutierrez, C.; Madrid, N.; Terron, S. D.; Marti, P.; Ansa, U.; Serrano, S.; Vivancos, M. J.; Bernal, E.; Cano, A.; Garcia, A. A.; Urbieta, J. B.; Munoz, A.; Alcaraz, M. J.; Villalba, M. D.; Pena, A.; Munoz, L.; Vinuesa, D.; Martinez-Montes, C.; Guerrero-Beltran, C.; Del Romero, J.; Rodriguez, C.; Puerta, T.; Carrio, J. C.; Vera, M.; Ballesteros, J.; Ayerdi, O.; Antela López, Antonio; Losada Arias, Elena; Aguilera Guirao, Antonio; Riera, M.; Penaranda, M.; Leyes, M.; Ribas, M. A.; Campins, A. A.; Vidal, C.; Fanjul, F.; Murillas, J.; Homar, F.; Santos, J.; Viciana, I.; Palacios, R.; Gonzalez, C. M.; Viciana, P.; Espinosa, N.; Lopez-Cortes, L. F.; Podzamczer, D.; Ferrer, E.; Imaz, A.; Tiraboschi, J.; Silva, A.; Saumoy, M.; Olalla, J.; del Arco, A.; de la Torre, J.; Prada, J. L.; Guerrero, Jmgd; Stachowski, J. P.; Amador, C.; Martinez, O. J.; Vera, F. J.; Martinez, L.; Garcia, J.; Alcaraz, B.; Jimeno, A.; Iglesias, A. C.; Souto, B. P.; de Cea, A. M.; Galera, C.; Albendin, H.; Perez, A.; Iborra, A.; Merlos, M. A.; Vidal, A.; Suarez-Garcia, I.; Malmierca, E.; Gonzalez-Ruano, P.; Rodrigo, D. M.; Mohamed-Balghata, M. O.; Vidal, M. A. G.; Pineda, J. A.; Macias, J.; Bernal, S.; Thomson, M.; Delgado, E.; Benito, S.; Montero, V.
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Identificadores
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Visualización o descarga de ficheros
Autor corporativo
CoRISFecha de publicación
2019Título de revista
Frontiers in Microbiology
Tipo de contenido
Artigo
DeCS
VIH-1MeSH
HIV-1Resumen
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.
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