A Phylogenetic Analysis of Human Immunodeficiency Virus Type 1 Sequences in Kiev: Findings Among Key Populations

Esther Fearnhill; Annabelle Gourlay

; Ruslan Malyuta; Ruth Simmons; R Bridget Ferns; Paul Grant; Eleni Nastouli; Iryna Karnets; Gary Murphy; Antonia Medoeva; +147 more... Yuri Kruglov; Alexander Yurchenko; Kholoud Porter; Julia Del Amo; Laurence Meyer; Heiner C Bucher; Geneviève Chêne; Osamah Hamouda; Deenan Pillay; Maria Prins; Magda Rosinska; Caroline Sabin; Giota Touloumi; Kholoud Porter; Ashley Olson; Andrea Cartier; Lorraine Fradette; Sarah Walker; Abdel Babiker; Heiner C Bucher; Andrea De Luca; Martin Fisher; Roberto Muga; Tony Kelleher; David Cooper; Pat Grey; Robert Finlayson; Mark Bloch; Tony Kelleher; Tim Ramacciotti; Linda Gelgor; David Cooper; Don Smith; Robert Zangerle; John Gill; Irja Lutsar; Geneviève Chêne; Francois Dabis; Rodolphe Thiebaut; Dominique Costagliola; Marguerite Guiguet; Philippe Vanhems; Marie-Laure Chaix; Jade Ghosn; Laurence Meyer; Faroudy Boufassa; Osamah Hamouda; Karolin Meixenberger; Norbert Bannert; Barbara Bartmeyer; Anastasia Antoniadou; Georgios Chrysos; Georgios L Daikos; Giota Touloumi; Nikos Pantazis; Olga Katsarou; Giovanni Rezza; Maria Dorrucci; Antonella d’Arminio Monforte; Andrea De Luca; Maria Prins; Ronald Geskus; Jannie van der Helm; Hanneke Schuitemaker; Mette Sannes; Oddbjorn Brubakk; Anne-Marte Bakken Kran; Magdalena Rosinska; Roberto Muga; Jordi Tor; Patricia Garcia de Olalla; Joan Cayla; Julia del Amo; Santiago Moreno; Susana Monge; Julia Del Amo; Jorge del Romero; Santiago Pérez-Hoyos; Anders Sönnerborg; Heiner C Bucher; Huldrych Günthard; Alexandra Scherrer; Ruslan Malyuta; Gary Murphy; Kholoud Porter; Anne Johnson; Andrew Phillips; Abdel Babiker; Deenan Pillay; Charles Morrison; Robert Salata; Roy Mugerwa; Tsungai Chipato; Matt A Price; Jill Gilmour; Anatoli Kamali; Etienne Karita; Fiona Burns; Geneviève Chêne; Dominique Costagliola; Carlo Giaquinto; Jesper Grarup; Ole Kirk; Laurence Meyer; Heather Bailey; Alain Volny Anne; Alex Panteleev; Andrew Phillips; Kholoud Porter; Claire Thorne; Jean-Pierre Aboulker; Jan Albert; Silvia Asandi; Geneviève Chêne; Dominique Costagliola; Antonella d’Arminio Monforte; Stéphane De Wit; Peter Reiss; Julia Del Amo; José Gatell; Carlo Giaquinto; Osamah Hamouda; Igor Karpov; Bruno Ledergerber; Jens Lundgren; Ruslan Malyuta; Claus Møller; Kholoud Porter; Maria Prins; Aza Rakhmanova; Jürgen Rockstroh; Manjinder Sandhu; Claire Thorne; Giota Touloumi; Alain Volny Anne; David Cooper; Nikos Dedes; Kevin Fenton; David Pizzuti; Marco Vitoria; Silvia Faggion; Lorraine Fradette; Richard Frost; Andrea Cartier; Dorthe Raben; Christine Schwimmer; Martin Scott; (2017) A Phylogenetic Analysis of Human Immunodeficiency Virus Type 1 Sequences in Kiev: Findings Among Key Populations. Clinical Infectious Diseases, 65 (7). pp. 1127-1135. ISSN 1058-4838 DOI: 10.1093/cid/cix499

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Background: The human immunodeficiency virus (HIV) epidemic in Ukraine has been driven by a rapid rise among people who inject drugs, but recent studies have shown an increase through sexual transmission. Methods: Protease and reverse transcriptase sequences from 876 new HIV diagnoses (April 2013–March 2015) in Kiev were linked to demographic data. We constructed phylogenetic trees for 794 subtype A1 and 64 subtype B sequences and identified factors associated with transmission clustering. Clusters were defined as ≥2 sequences, ≥80% local branch support, and maximum genetic distance of all sequence pairs in the cluster ≤2.5%. Recent infection was determined through the limiting antigen avidity enzyme immunoassay. Sequences were analyzed for transmitted drug resistance mutations. Results Thirty percent of subtype A1 and 66% of subtype B sequences clustered. Large clusters (maximum 11 sequences) contained mixed risk groups. In univariate analysis, clustering was significantly associated with subtype B compared to A1 (odds ratio [OR], 4.38 [95% confidence interval {CI}, 2.56–7.50]); risk group (OR, 5.65 [95% CI, 3.27–9.75]) for men who have sex with men compared to heterosexual males; recent, compared to long-standing, infection (OR, 2.72 [95% CI, 1.64–4.52]); reported sex work contact (OR, 1.93 [95% CI, 1.07–3.47]); and younger age groups compared with age ≥36 years (OR, 1.83 [95% CI, 1.10–3.05] for age ≤25 years). Females were associated with lower odds of clustering than heterosexual males (OR, 0.49 [95% CI, .31–.77]). In multivariate analysis, risk group, subtype, and age group were independently associated with clustering (P < .001, P = .007, and P = .033, respectively). Eighteen sequences (2.1%) indicated evidence of transmitted drug resistance. Conclusions Our findings suggest high levels of transmission and bridging between risk groups.