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. 2017 Jan-Feb;22(1):12307-12315.

HIV transmission clusters among injecting drug users in Romania

Aura Temereanca  1   2 , Cristiana Oprea  3   4 , Joel O Wertheim  5 , Irina Ianache  4 , Emanoil Ceausu  3   4 , Costin Cernescu  2 , Sanjay R Mehta  5 , Simona Ruta  1   2
Affiliations

HIV transmission clusters among injecting drug users in Romania

Aura Temereanca et al. Rom Biotechnol Lett. 2017 Jan-Feb.

Abstract

Injection drug use is increasingly an important route of HIV transmission in Romania (from 1.5% of the newly diagnosed cases prior to 2010 to 31% in 2013). In this study we investigated the viral characteristics and relationships in newly HIV infected persons who inject drugs in Bucharest, Romania.

Results: HIV-1 pol sequencing, followed by phylogenetic and clustering analysis was performed on blood from 37 injecting drug users (IDUs) newly diagnosed with HIV infection. While HIV subtype F1, the dominant strain in Romania since 1990, remains prevalent, new subtypes were found including G, B, B/G and B/F recombinants. Overall, 27 of the available sequences (72.9%) clustered with at least one other. Network and phylogenetic analysis revealed tight monophyletic clusters for both subtypes F and G, with short genetic distances between sequences, suggesting recent numerous acute to acute transmissions or single burst-type episodes. No transmitted drug-resistance mutations were identified. Greater immunosuppression was present in subjects forming the subtype G cluster, possibly indicating a faster rate of progression associated with this subtype.

Conclusions: The recent increasing numbers of IDU related HIV transmissions in Bucharest, has resulted in closely-knit transmission networks that maychange the genetic profile of the local HIV epidemic.

Keywords: HIV; drug use; subtype F; subtype G; transmission networks.

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Figures

Figure 1
Figure 1. Phylogenetic trees for (A) subtype F and (B) subtype G
(A) A maximum likelihood phylogenetic tree demonstrated a large HIV transmission cluster within the sequences subtyped as F1. (B) A maximum likelihood phylogenetic tree demonstrated grouping of all the 10 sequences subtyped as G, with an HIV transmission cluster of 7 samples.
Figure 2
Figure 2. Inferred transmission clusters of subtypes F and G by genetic distance analysis
Linkages are represented by network edges, and individuals by network nodes. A cluster includes all connected individuals, and all are less than 1.5% divergent from at least one other, but not necessarily less than 1.5% divergent between all within the cluster.
See this image and copyright information in PMC

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