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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 ; Baldvinsdóttir, Guðrún; Indriðason, Hlynur; Björnsdóttir, Thora Björg; Widell, Anders LU ; Gottfreðsson, Magnús; Löve, Arthur and Medstrand, Patrik LU (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
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
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
2018-05-06 04:30:05
@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},
  keyword      = {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          = {http://dx.doi.org/10.1016/j.meegid.2017.01.004},
  volume       = {49},
  year         = {2017},
}