Evangelia Georgia Kostaki , Sotirios Roussos , Anastasia Maria Kefala , Stefanos Limnaios , Mina Psichogiou , Eleni Papachristou , Georgios Nikolopoulos , Eleni Flountzi , Samuel R. Friedman , Pagona Lagiou , Angelos Hatzakis , Vana Sypsa , Gkikas Magiorkinis , Apostolos Beloukas , Dimitrios Paraskevis
{"title":"希腊雅典艾滋病毒爆发后注射吸毒者中艾滋病毒的分子流行病学:缓慢燃烧 \"爆发的证据","authors":"Evangelia Georgia Kostaki , Sotirios Roussos , Anastasia Maria Kefala , Stefanos Limnaios , Mina Psichogiou , Eleni Papachristou , Georgios Nikolopoulos , Eleni Flountzi , Samuel R. Friedman , Pagona Lagiou , Angelos Hatzakis , Vana Sypsa , Gkikas Magiorkinis , Apostolos Beloukas , Dimitrios Paraskevis","doi":"10.1016/j.meegid.2024.105597","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>New diagnoses of HIV-1 infection among people who inject drugs (PWID) in Athens, Greece, saw a significant increase in 2011 and a subsequent decline after 2013. Despite this, ongoing HIV-1 transmission persisted from 2014 to 2020 within this population. Our objective was to estimate the time of infection for PWID in Athens following the HIV-1 outbreak, explore the patterns of HIV-1 dispersal over time, and determine the duration from infection to diagnosis.</p></div><div><h3>Methods</h3><p>Time from HIV-1 infection to diagnosis was estimated for 844 individuals infected within 4 PWID-specific clusters and for 8 PWID infected with sub-subtype A6 diagnosed during 2010–2019. Phylogeny reconstruction was performed using the maximum-likelihood method. HIV-1 infection dates were based on molecular clock calculations.</p></div><div><h3>Results</h3><p>In total 86 of 92 (93.5%) sequences from PWID diagnosed during 2016–2019 were either related to the previously identified PWID-specific clusters (<em>n</em> = 81) or belonged to a new A6 cluster (<em>n</em> = 5). The median time between infection and diagnosis was 0.42 years during the outbreak period and 0.70 years during 2016–2019 (<em>p</em> < 0.001). The proportion of clustered sequences from PWID was very low at 5.3% during the pre-outbreak period (1998–2009), saw an increase to 41.7% one year before the outbreak in 2010, and consistently remained high during the whole period after 2011, spanning the post-outbreak period (2016–2019) with a range from 92.9% to 100%.</p></div><div><h3>Conclusions</h3><p>The substantial proportion of clustered infections (93.5%) during 2016–2019 implies a persistent ‘slow burn’ HIV outbreak among PWID in Athens, suggesting that the outbreak was not successfully eliminated. The consistently high proportion of clustered sequences since the onset of the outbreak suggests the persistence of ongoing HIV-1 transmission attributed to injection practices. Our findings underscore the importance of targeted interventions among PWID, considering the ongoing transmission rate and prolonged time from infection to diagnosis.</p></div>","PeriodicalId":54986,"journal":{"name":"Infection Genetics and Evolution","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1567134824000480/pdfft?md5=03ab3ffc63d9361b3ab3a5b1a470a81e&pid=1-s2.0-S1567134824000480-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Molecular epidemiology of HIV among people who inject drugs after the HIV-outbreak in Athens, Greece: Evidence for a ‘slow burn’ outbreak\",\"authors\":\"Evangelia Georgia Kostaki , Sotirios Roussos , Anastasia Maria Kefala , Stefanos Limnaios , Mina Psichogiou , Eleni Papachristou , Georgios Nikolopoulos , Eleni Flountzi , Samuel R. Friedman , Pagona Lagiou , Angelos Hatzakis , Vana Sypsa , Gkikas Magiorkinis , Apostolos Beloukas , Dimitrios Paraskevis\",\"doi\":\"10.1016/j.meegid.2024.105597\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>New diagnoses of HIV-1 infection among people who inject drugs (PWID) in Athens, Greece, saw a significant increase in 2011 and a subsequent decline after 2013. Despite this, ongoing HIV-1 transmission persisted from 2014 to 2020 within this population. Our objective was to estimate the time of infection for PWID in Athens following the HIV-1 outbreak, explore the patterns of HIV-1 dispersal over time, and determine the duration from infection to diagnosis.</p></div><div><h3>Methods</h3><p>Time from HIV-1 infection to diagnosis was estimated for 844 individuals infected within 4 PWID-specific clusters and for 8 PWID infected with sub-subtype A6 diagnosed during 2010–2019. Phylogeny reconstruction was performed using the maximum-likelihood method. HIV-1 infection dates were based on molecular clock calculations.</p></div><div><h3>Results</h3><p>In total 86 of 92 (93.5%) sequences from PWID diagnosed during 2016–2019 were either related to the previously identified PWID-specific clusters (<em>n</em> = 81) or belonged to a new A6 cluster (<em>n</em> = 5). The median time between infection and diagnosis was 0.42 years during the outbreak period and 0.70 years during 2016–2019 (<em>p</em> < 0.001). The proportion of clustered sequences from PWID was very low at 5.3% during the pre-outbreak period (1998–2009), saw an increase to 41.7% one year before the outbreak in 2010, and consistently remained high during the whole period after 2011, spanning the post-outbreak period (2016–2019) with a range from 92.9% to 100%.</p></div><div><h3>Conclusions</h3><p>The substantial proportion of clustered infections (93.5%) during 2016–2019 implies a persistent ‘slow burn’ HIV outbreak among PWID in Athens, suggesting that the outbreak was not successfully eliminated. The consistently high proportion of clustered sequences since the onset of the outbreak suggests the persistence of ongoing HIV-1 transmission attributed to injection practices. Our findings underscore the importance of targeted interventions among PWID, considering the ongoing transmission rate and prolonged time from infection to diagnosis.</p></div>\",\"PeriodicalId\":54986,\"journal\":{\"name\":\"Infection Genetics and Evolution\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-04-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1567134824000480/pdfft?md5=03ab3ffc63d9361b3ab3a5b1a470a81e&pid=1-s2.0-S1567134824000480-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infection Genetics and Evolution\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1567134824000480\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Genetics and Evolution","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1567134824000480","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Molecular epidemiology of HIV among people who inject drugs after the HIV-outbreak in Athens, Greece: Evidence for a ‘slow burn’ outbreak
Background
New diagnoses of HIV-1 infection among people who inject drugs (PWID) in Athens, Greece, saw a significant increase in 2011 and a subsequent decline after 2013. Despite this, ongoing HIV-1 transmission persisted from 2014 to 2020 within this population. Our objective was to estimate the time of infection for PWID in Athens following the HIV-1 outbreak, explore the patterns of HIV-1 dispersal over time, and determine the duration from infection to diagnosis.
Methods
Time from HIV-1 infection to diagnosis was estimated for 844 individuals infected within 4 PWID-specific clusters and for 8 PWID infected with sub-subtype A6 diagnosed during 2010–2019. Phylogeny reconstruction was performed using the maximum-likelihood method. HIV-1 infection dates were based on molecular clock calculations.
Results
In total 86 of 92 (93.5%) sequences from PWID diagnosed during 2016–2019 were either related to the previously identified PWID-specific clusters (n = 81) or belonged to a new A6 cluster (n = 5). The median time between infection and diagnosis was 0.42 years during the outbreak period and 0.70 years during 2016–2019 (p < 0.001). The proportion of clustered sequences from PWID was very low at 5.3% during the pre-outbreak period (1998–2009), saw an increase to 41.7% one year before the outbreak in 2010, and consistently remained high during the whole period after 2011, spanning the post-outbreak period (2016–2019) with a range from 92.9% to 100%.
Conclusions
The substantial proportion of clustered infections (93.5%) during 2016–2019 implies a persistent ‘slow burn’ HIV outbreak among PWID in Athens, suggesting that the outbreak was not successfully eliminated. The consistently high proportion of clustered sequences since the onset of the outbreak suggests the persistence of ongoing HIV-1 transmission attributed to injection practices. Our findings underscore the importance of targeted interventions among PWID, considering the ongoing transmission rate and prolonged time from infection to diagnosis.
期刊介绍:
(aka Journal of Molecular Epidemiology and Evolutionary Genetics of Infectious Diseases -- MEEGID)
Infectious diseases constitute one of the main challenges to medical science in the coming century. The impressive development of molecular megatechnologies and of bioinformatics have greatly increased our knowledge of the evolution, transmission and pathogenicity of infectious diseases. Research has shown that host susceptibility to many infectious diseases has a genetic basis. Furthermore, much is now known on the molecular epidemiology, evolution and virulence of pathogenic agents, as well as their resistance to drugs, vaccines, and antibiotics. Equally, research on the genetics of disease vectors has greatly improved our understanding of their systematics, has increased our capacity to identify target populations for control or intervention, and has provided detailed information on the mechanisms of insecticide resistance.
However, the genetics and evolutionary biology of hosts, pathogens and vectors have tended to develop as three separate fields of research. This artificial compartmentalisation is of concern due to our growing appreciation of the strong co-evolutionary interactions among hosts, pathogens and vectors.
Infection, Genetics and Evolution and its companion congress [MEEGID](http://www.meegidconference.com/) (for Molecular Epidemiology and Evolutionary Genetics of Infectious Diseases) are the main forum acting for the cross-fertilization between evolutionary science and biomedical research on infectious diseases.
Infection, Genetics and Evolution is the only journal that welcomes articles dealing with the genetics and evolutionary biology of hosts, pathogens and vectors, and coevolution processes among them in relation to infection and disease manifestation. All infectious models enter the scope of the journal, including pathogens of humans, animals and plants, either parasites, fungi, bacteria, viruses or prions. The journal welcomes articles dealing with genetics, population genetics, genomics, postgenomics, gene expression, evolutionary biology, population dynamics, mathematical modeling and bioinformatics. We also provide many author benefits, such as free PDFs, a liberal copyright policy, special discounts on Elsevier publications and much more. Please click here for more information on our author services .