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

• Published in: Infection, Genetics and Evolution
• Main Authors: Sallam, Malik, Esbjörnsson, Joakim, Baldvinsdóttir, Guðrún, Indriðason, Hlynur, Björnsdóttir, Thora Björg, Widell, Anders, Gottfreðsson, Magnús, Löve, Arthur, Medstrand, Patrik
• Other Authors: 1 Lund Univ, Dept Translat Med, Malmo, Sweden Show the Organization-Enhanced name(s) 2 Univ Oxford, Nuffield Dept Med, Oxford, England Show the Organization-Enhanced name(s) 3 Karolinska Inst, Microbiol Tumor & Cell Biol, Stockholm, Sweden Show the Organization-Enhanced name(s) 4 Landspitali Univ Hosp, Dept Virol, Reykjavik, Iceland Show the Organization-Enhanced name(s) 5 Univ Iceland, Fac Med, Sch Hlth Sci, Reykjavik, Iceland Show the Organization-Enhanced name(s) 6 Landspitali Univ Hosp, Dept Infect Dis, Reykjavik, Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier Science 2017
• Subjects: Alnæmi; Faraldsfræði; Fíkniefnaneytendur; TMD12; VIR12; HIV; Molecular Epidemiology; Drug Users; Iceland
• Online Access: http://hdl.handle.net/2336/620148; https://doi.org/10.1016/j.meegid.2017.01.004

To access publisher's full text version of this article click on the hyperlink at the bottom of the page 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 1985-2012, 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. Swedish Research Council, Sweden Faculty of Medicine, Lund University, Sweden University of Iceland Research Fund University of ...