The changing epidemiological profile of HIV-1 subtype B epidemic in Ukraine

Background While HIV‐1 subtype B has caused a large epidemic in the western world, its transmission in Ukraine remains poorly understood. We assessed the genetic diversity of HIV‐1 subtype B viruses circulating in Ukraine, characterized transmission group structure, and estimated key evolutionary and epidemiological parameters. Methods We analysed 120 HIV‐1 subtype B pol sequences (including 46 newly generated) sampled from patients residing in 11 regions of Ukraine between 2002‐2017. Phylogenies were estimated using maximum likelihood and Bayesian phylogenetic methods. A Bayesian molecular clock coalescent analysis was used to estimate effective population size dynamics and to date the most recent common ancestors of identified clades. A phylodynamic birth‐death model was used to estimate the effective reproductive number (Re) of these clades. Results We identified two phylogenetically distinct predominantly Ukrainian (≥75%) clades of HIV‐1 subtype B. We found no significant transmission group structure for either clade, suggesting frequent mixing among transmission groups. The estimated dates of origin of both subtype B clades were around early 1970s, similar to the introduction of HIV‐1 subtype A into Ukraine. Re for Clade 1 was estimated to be 1.42 (95% HPD 1.26‐1.56) and 1.69 (95% HPD 1.49‐1.84) for Clade 2. Discussion The subtype B epidemic in the country is no longer concentrated in specific geographical regions or transmission groups. The study results highlight the necessity for strengthening preventive and monitoring efforts to reduce the further spread of HIV‐1 subtype B.</p

The changing epidemiological profile of HIV-1 subtype B epidemic in Ukraine

Background While HIV‐1 subtype B has caused a large epidemic in the western world, its transmission in Ukraine remains poorly understood. We assessed the genetic diversity of HIV‐1 subtype B viruses circulating in Ukraine, characterized transmission group structure, and estimated key evolutionary and epidemiological parameters. Methods We analysed 120 HIV‐1 subtype B pol sequences (including 46 newly generated) sampled from patients residing in 11 regions of Ukraine between 2002‐2017. Phylogenies were estimated using maximum likelihood and Bayesian phylogenetic methods. A Bayesian molecular clock coalescent analysis was used to estimate effective population size dynamics and to date the most recent common ancestors of identified clades. A phylodynamic birth‐death model was used to estimate the effective reproductive number (Re) of these clades. Results We identified two phylogenetically distinct predominantly Ukrainian (≥75%) clades of HIV‐1 subtype B. We found no significant transmission group structure for either clade, suggesting frequent mixing among transmission groups. The estimated dates of origin of both subtype B clades were around early 1970s, similar to the introduction of HIV‐1 subtype A into Ukraine. Re for Clade 1 was estimated to be 1.42 (95% HPD 1.26‐1.56) and 1.69 (95% HPD 1.49‐1.84) for Clade 2. Discussion The subtype B epidemic in the country is no longer concentrated in specific geographical regions or transmission groups. The study results highlight the necessity for strengthening preventive and monitoring efforts to reduce the further spread of HIV‐1 subtype B.</p

Molecular epidemiology reveals the role of war in the spread of HIV in Ukraine.

Ukraine has one of the largest HIV epidemics in Europe, historically driven by people who inject drugs (PWID). The epidemic showed signs of stabilization in 2012, but the recent war in eastern Ukraine may be reigniting virus spread. We investigated the movement of HIV-infected people within Ukraine before and during the conflict. We analyzed HIV-1 subtype-A pol nucleotide sequences sampled during 2012-2015 from 427 patients of 24 regional AIDS centers and used phylogeographic analysis to reconstruct virus movement among different locations in Ukraine. We then tested for correlations between reported PWID behaviors and reconstructed patterns of virus spread. Our analyses suggest that Donetsk and Lugansk, two cities not controlled by the Ukrainian government in eastern Ukraine, were significant exporters of the virus to the rest of the country. Additional analyses showed that viral dissemination within the country changed after 2013. Spearman correlation analysis showed that incoming virus flow was correlated with the number of HIV-infected internally displaced people. Additionally, there was a correlation between more intensive virus movement and locations with a higher proportion of PWID practicing risky sexual behaviors. Our findings suggest that effective prevention responses should involve internally displaced people and people who frequently travel to war-affected regions. Scale-up of harm reduction services for PWID will be an important factor in preventing new local HIV outbreaks in Ukraine

Molecular epidemiology reveals the role of war in the spread of HIV in Ukraine.

Ukraine has one of the largest HIV epidemics in Europe, historically driven by people who inject drugs (PWID). The epidemic showed signs of stabilization in 2012, but the recent war in eastern Ukraine may be reigniting virus spread. We investigated the movement of HIV-infected people within Ukraine before and during the conflict. We analyzed HIV-1 subtype-A pol nucleotide sequences sampled during 2012-2015 from 427 patients of 24 regional AIDS centers and used phylogeographic analysis to reconstruct virus movement among different locations in Ukraine. We then tested for correlations between reported PWID behaviors and reconstructed patterns of virus spread. Our analyses suggest that Donetsk and Lugansk, two cities not controlled by the Ukrainian government in eastern Ukraine, were significant exporters of the virus to the rest of the country. Additional analyses showed that viral dissemination within the country changed after 2013. Spearman correlation analysis showed that incoming virus flow was correlated with the number of HIV-infected internally displaced people. Additionally, there was a correlation between more intensive virus movement and locations with a higher proportion of PWID practicing risky sexual behaviors. Our findings suggest that effective prevention responses should involve internally displaced people and people who frequently travel to war-affected regions. Scale-up of harm reduction services for PWID will be an important factor in preventing new local HIV outbreaks in Ukraine

Spread of Chikungunya virus East/Central/South African genotype in Northeast Brazil.

We investigated an outbreak of exanthematous illness in Maceió by using molecular surveillance; 76% of samples tested positive for chikungunya virus. Genetic analysis of 23 newly generated genomes identified the East/Central/South African genotype, suggesting that this lineage has persisted since mid-2014 in Brazil and may spread in the Americas and beyond