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. 2016 Dec:46:169-179.
doi: 10.1016/j.meegid.2016.05.041. Epub 2016 Jun 2.

The global spread of HIV-1 subtype B epidemic

Gkikas Magiorkinis  1 , Konstantinos Angelis  2 , Ioannis Mamais  2 , Aris Katzourakis  3 , Angelos Hatzakis  2 , Jan Albert  4 , Glenn Lawyer  5 , Osamah Hamouda  6 , Daniel Struck  7 , Jurgen Vercauteren  8 , Annemarie Wensing  9 , Ivailo Alexiev  10 , Birgitta Åsjö  11 , Claudia Balotta  12 , Perpétua Gomes  13 , Ricardo J Camacho  8 , Suzie Coughlan  14 , Algirdas Griskevicius  15 , Zehava Grossman  16 , Anders Horban  17 , Leondios G Kostrikis  18 , Snjezana J Lepej  19 , Kirsi Liitsola  20 , Marek Linka  21 , Claus Nielsen  22 , Dan Otelea  23 , Roger Paredes  24 , Mario Poljak  25 , Elizabeth Puchhammer-Stöckl  26 , Jean Claude Schmit  7 , Anders Sönnerborg  27 , Danica Staneková  28 , Maja Stanojevic  29 , Dora C Stylianou  18 , Charles A B Boucher  30 ; SPREAD program; Georgios Nikolopoulos  2 , Tetyana Vasylyeva  3 , Samuel R Friedman  31 , David van de Vijver  32 , Gioacchino Angarano  33 , Marie-Laure Chaix  34 , Andrea de Luca  35 , Klaus Korn  36 , Clive Loveday  37 , Vincent Soriano  38 , Sabine Yerly  39 , Mauricio Zazzi  40 , Anne-Mieke Vandamme  8 , Dimitrios Paraskevis  41
Affiliations

The global spread of HIV-1 subtype B epidemic

Gkikas Magiorkinis et al. Infect Genet Evol. 2016 Dec.

Abstract
in English, Modern Greek (1453-)

Human immunodeficiency virus type 1 (HIV-1) was discovered in the early 1980s when the virus had already established a pandemic. For at least three decades the epidemic in the Western World has been dominated by subtype B infections, as part of a sub-epidemic that traveled from Africa through Haiti to United States. However, the pattern of the subsequent spread still remains poorly understood. Here we analyze a large dataset of globally representative HIV-1 subtype B strains to map their spread around the world over the last 50years and describe significant spread patterns. We show that subtype B travelled from North America to Western Europe in different occasions, while Central/Eastern Europe remained isolated for the most part of the early epidemic. Looking with more detail in European countries we see that the United Kingdom, France and Switzerland exchanged viral isolates with non-European countries than with European ones. The observed pattern is likely to mirror geopolitical landmarks in the post-World War II era, namely the rise and the fall of the Iron Curtain and the European colonialism. In conclusion, HIV-1 spread through specific migration routes which are consistent with geopolitical factors that affected human activities during the last 50years, such as migration, tourism and trade. Our findings support the argument that epidemic control policies should be global and incorporate political and socioeconomic factors.

  1. •

    We describe and quantify the global spread of the HIV-1 subtype B, the most prevalent in the Western World

  2. •

    We show that the virus did not spread randomly by “diffusion” away from places with high virus burden

  3. •

    Significant migration routes are consistent with geopolitical factors that affected human activities.

  4. •

    Epidemic control policies should be global and incorporate political and socioeconomic factors

  5. •

    Hidden underlying ecological pathways that define how pandemics of viral infections spread around the world.

Keywords: HIV-1; Migration; Migration pattern; Phylogeography; Subtype B.

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Figures

Fig. 1
Fig. 1
ML phylogeographic tree showing viral clades in different colors according to sampling area. A: Clades from eight different geographic areas are highlighted. B: Clades are separated into North American and other regions and C: clades are separated into European and non-European. W. Europe: Western Europe, C.E. Europe: Central/Eastern Europe, C.S.·America: Central and South America, N. America: North America.
Fig. 2
Fig. 2
Global migration patterns of HIV-1 subtype B estimated by statistical phylogeography under the geographical grouping strategy 1. Colors indicate different geographic regions (highlighted countries) from which HIV-1 sequences were available. Pins represent different geographic regions (group of highlighted countries) and arrows indicate the direction of subtype B spread.
Fig. 3
Fig. 3
A: Scatter plot of the total number of HIV-1 subtype B infected individuals in log scale per country/region versus the number of exporting pathways for each country/region. The solid line is the fitted regression line. R2 is the coefficient of determination and p is the p-value of the regression model. Country names are shown only for the statistically significant regression in ISO (International Organization for Standardization) three-letter codes; ALB: Albania, AUT: Austria, BEL: Belgium, BGR: Bulgaria, BLR: Belarus, CHE: Switzerland, CZE: Czech Republic, DEU: Germany, DNK: Denmark, ESP: Spain, EST: Estonia, FIN: Finland, FRA: France, GBR: United Kingdom, GRC: Greece, IRL: Ireland, ISR: Israel, ITA: Italy, LTV: Latvia, LUX: Luxembourg, NLD: Netherlands, NOR: Norway, POL: Poland, PRT: Portugal, ROU: Romania, SRB: Serbia, SVK: Slovakia, SVN: Slovenia, SWE: Sweden, UKR: Ukraine. B: Same as A, but with the number of importing pathways for each country/region.
See this image and copyright information in PMC

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