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Molecular epidemiology of HIV-1 in Iceland : Early introductions, transmission dynamics and recent outbreaks among injection drug users

Sallam, Malik LU ; Esbjörnsson, Joakim LU orcid ; Baldvinsdóttir, Guðrún ; Indriðason, Hlynur ; Björnsdóttir, Thora Björg ; Widell, Anders LU ; Gottfreðsson, Magnús ; Löve, Arthur and Medstrand, Patrik LU orcid (2017) In Infection, Genetics and Evolution 49. p.157-163
Abstract

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%,... (More)

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 between 1985 and 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.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
HIV Infections: epidemiology, Iceland, Phylogeny, Subtype B, Non-subtype B, MSM, Heterosexual, BEAST
in
Infection, Genetics and Evolution
volume
49
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:85010073032
  • wos:000395463900024
  • pmid:28082188
ISSN
1567-7257
DOI
10.1016/j.meegid.2017.01.004
language
English
LU publication?
yes
id
67bd6d80-a200-4837-a1dc-39bc95add282
date added to LUP
2017-01-24 14:32:51
date last changed
2025-10-20 05:17:41
@article{67bd6d80-a200-4837-a1dc-39bc95add282,
  abstract     = {{<p>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 between 1985 and 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.</p>}},
  author       = {{Sallam, Malik and Esbjörnsson, Joakim and Baldvinsdóttir, Guðrún and Indriðason, Hlynur and Björnsdóttir, Thora Björg and Widell, Anders and Gottfreðsson, Magnús and Löve, Arthur and Medstrand, Patrik}},
  issn         = {{1567-7257}},
  keywords     = {{HIV Infections: epidemiology; Iceland; Phylogeny; Subtype B; Non-subtype B; MSM; Heterosexual; BEAST}},
  language     = {{eng}},
  month        = {{01}},
  pages        = {{157--163}},
  publisher    = {{Elsevier}},
  series       = {{Infection, Genetics and Evolution}},
  title        = {{Molecular epidemiology of HIV-1 in Iceland : Early introductions, transmission dynamics and recent outbreaks among injection drug users}},
  url          = {{https://lup.lub.lu.se/search/files/27487761/20233236.pdf}},
  doi          = {{10.1016/j.meegid.2017.01.004}},
  volume       = {{49}},
  year         = {{2017}},
}