Presentación de PowerPoint - Programme-at-a

Presentación de PowerPoint - Programme-at-a

TUPEA060
New HIV-1 diagnoses in Spain frequently group in clusters of
subtype B and non-subtype B genetic forms
Elena Delgado*, Jesús Martínez, Mª Teresa Cuevas, Aurora Fernández-García, Yolanda Vega, Vanessa Montero,
Cristina Carrera, Mónica Sánchez, Elena García-Bodas, Lucía Pérez-Álvarez, Michael M. Thomson*
and The Spanish Group for the Study of HIV-1 Antiretroviral Drug Resistance and Tropism†.
Unidad de Biología y Variabilidad del VIH, Centro Nacional de Microbiología, Instituto de Salud Carlos III. Majadahonda, Madrid, Spain.
*e-mail: [email protected]; [email protected]
Background:
B08
A recent increase in phylogenetic clustering among new HIV-1 infections has been observed in many countries, frequently associated with men who have sex
with men (MSM). Here we analyze phylogenetic clustering among newly diagnosed HIV-1 infections of 6 regions of Spain.
B10
B49
B75
B36
B43
B14
B01
B05
B.RF
B26
B29
B11
B54
B35
B.SF2
B.HXB2
B.JRFL
B32
B06
B156
Methods:
Samples were collected from HIV-1-infected individuals newly diagnosed in 2013 and 2014, attended in 19 hospitals from 6 Spanish regions (Galicia,
Basque Country, Navarre, Castilla y León, Madrid, and Extremadura).
RNA extracted from plasma was used for RT-PCR amplification and sequencing of protease and reverse transcriptase (PR-RT), env V3 region, or both.
Phylogenetic analyses were performed via maximum likelihood with RAxML and PhyML, applying the GTR+G+I evolutionary model.
Clusters were defined as those supported by bootstrap values ≥90% with RAxML and by aLRT SH-like values ≥0.9 with PhyML, and comprising ≥4
individuals with a majority being native Spanish. In these analyses, sequences from samples collected in previous years in Spain and sequenced by us
were also included.
Results:
CRF06_cpx
CRF02_AG
CRF19_cpx
CRF27_cpx
CRF29_BF
CRF01_AE
G
B04
B12
B31
22
8
6
CRF47_BF
B70
Non B
142
(31%)
B
314
27
6
B
28
B07
31
F1
B50
2
N= 456
D
14
C
URFs
14
B09
B28
A1
B13
Figure 1. Distribution of HIV-1 genetic forms of samples from 456
individuals newly diagnosed of HIV-1 infection in 2013 and 2014. Samples
were sequenced, either both in PR-RT and V3 (n=272), only in PR-RT (n=154),
or only in V3 (n=30). 142 (31%) non-subtype B infections were identified.
Number of clusters
A)
39
40
30
26
non MSM
17
20
10
10
0
MSM
CRF47_BF
D.ELI
D.84ZE085
Figure 2. Geographic distribution of new HIV-1 diagnoses (ND)
of this study. Most were from Basque Country (n=222), Galicia
(n=141), and Navarre (n=55). Locations of cities where hospitals
are located are indicated with red dots. 92 clusters were
identified. ND grouping in clusters of ≥4 individuals were 232
(51% of total). Pie charts represent proportions of ND belonging
to transmission clusters of ≥4 individuals. Chart sizes are
proportional to the number of ND analyzed in each region.
A1
14
4
Genetic
form
A1
C
C
F1
F1
CRF01_AE
CRF02_AG
CRF02_AG
CRF02_AG
CRF02_AG
CRF02_AG
CRF02_AG
CRF02_AG
CRF19_cpx
CRF47_BF
BF
BF
BF
BG
BG
Cluster
size
35
8
14
130
15
4
32
10
8
6
4
5
4
4
14
5
5
7
33
15
358
ND
2013-2014
13
1
7
18
1
2
4
2
1
2
1
1
1
2
3
2
1
6
2
1
71
% ND
in cluster
37%
13%
50%
14%
7%
50%
13%
20%
13%
33%
25%
20%
25%
50%
21%
40%
20%
86%
6%
7%
20%
Figure 4. Distribution of clusters according to size and transmission
among MSM. (A) Distribution of clusters by size with indication of the
number of clusters associated with MSM (≥90% MSM in the cluster).
(B) Distribution of clusters by size with indication of total numbers of
ND individuals and of MSM within clusters of each size range.
Cluster
A1_1
C2
C7
F1_1
F1_2
CRF01_1
CRF02_1
CRF02_3
CRF02_6
CRF02_7
CRF02_8
CRF02_10
CRF02_11
CRF19_1
CRF47_1
CRF12B
BF_2
BF_3
CRF_BG
CRF14B
Total
Conclusions:
Table 1. Data for the 20 clusters of non-subtype B genetic
forms, which include total number of individuals, new
diagnoses of 2013-2014, proportion of these relative to the
total, and association with MSM (highlighted).
A high proportion of newly diagnosed HIV-1 infections in
Spain group in clusters of subtype B and non-subtype B
variants, most frequently among MSM.
ACKNOWLEDGEMENTS:
We thank Dr. José Antonio Taboada, Consellería de Sanidade, Xunta de Galicia, and Dr.
Daniel Zulaica, Unidad de Coordinación del Plan de Prevención y Control del SIDA,
Osakidetza-Servicio Vasco de Salud, for their support of this study.
Number of ND individuals
B)
5 to 9
10 to 19
Cluster size
120
≥20
103
100
80
61
60
56
97
40
20
0
non MSM
MSM
12
34
38
5
4
5 to 9
10 to 19
Cluster size
02_AG
G
22
14
4
CRF02_1
02 AG.DJ263
02 AG.CM52885
CRF02_3
02 AG.GH.-.G829
02 AG.G829
G.DRCBL
G.92NG083
14 BG.X623
14 BG.X397
14 BG.X421
14 BG.X605
CRF14B
A1.U455
A1.SE7253
A1.UG037
A1_1
H.VI991
H.90CF056
C.IN101
C.98BR004
C7
F1.MP0411
F1.FIN9363
F1.VI850
F1_2
F1.93BR020.1
≥20
The recent expansion of HIV-1 clusters in many countries
reflects an active dynamic of viral propagation via sexual
transmission, requiring the reinforcement of public
health measures aimed at the prevention of high risk
sexual behavior.
FUNDING:
• Dirección General de Farmacia, Ministerio de Sanidad, Servicios Sociales e Igualdad,
Spain, EC11-272;
• European Research Infrastructures for Poverty Related Diseases (EURIPRED). 7th
Framework Programme: FP7-Capacities-infrastructures-2012-1, grant # 312661;
• Instituto de Salud Carlos III, Subdirección General de Evaluación, y Fondo Europeo de
Desarrollo Regional (FEDER), Plan Nacional I + D + I, proyecto RD12/0017/0026;
• Consellería de Sanidade, Xunta de Galicia, Spain;
• Osakidetza-Servicio Vasco de Salud, Spain.
C
F1
F1_1
0.01
Figure 3. Maximum likelihood phylogenetic tree
of PR-RT including transmission clusters of ≥10
individuals. Branches in clusters are compressed
in triangles, with height proportional to the
number of samples.
† Spanish
Group for the Study of HIV-1 Antiretroviral Drug Resistance and Tropism:
Galicia:
Basque Country:
Other:
Hospital Arquitecto Marcide. Ferrol
Patricia Ordoñez
Hortensia Álvarez
Ana Mariño
Complejo Hospitalario Universitario de A
Coruña
Hospital de Basurto
Ramón Cisterna
Mª Dolores Suárez
Silvia Hernáez
Hospital de Cruces
Complejo Htal. De Navarra
Carmen Ezpeleta Baquedano
Angeles Cañizares
Mª de los Angeles Castro Iglesias
Hospital Lucus Augusti/Xeral Calde
Maria José López Alvarez
Complejo Hospitalario Universitario de
Orense
Jesús Corral
Luis Elorduy Otazua
Leyre López Soria
Koldo Aguirrebengoa
Carmen Hinojosa Mena-Bernal
Ricardo Fernández Rodríguez
Juan García Costa
Raúl Rodríguez
Complejo Hospitalario Universitario
Xeral-Cíes de Vigo
Hospital de Galdakao
Hospital El Bierzo
Mª José López de Goicoechea Carmen Raya Fernández
José Mayo
Hospital de León
Sara Calleja Antolín
Hospital Donostia
Carlos Gustavo Cilla Eguiluz
Julio Arrizabalaga
Hospital Infanta Cristina. Badajoz
Sonia Pérez Castro
Antonio Ocampo
Celia Miralles
Isabel Lopez Miragaya
Complejo Hospitalario Provincial de
Pontevedra
Matilde Trigo Daporta
Rafael Ojea de Castro
Julio Diz Arén
José Antonio Iribarren
Mª Julia Echevarría
Hospital de Txagorritxu
Mª Jesús Lezaun
José Joaquín Portu
Hospital Santiago Apóstol
Andrés Canut Blasco
Hospital Clínico Universitario de
Valladolid
Hospital Rio Hortega
Carmen Ramos Sánchez
Eugenio Garduño
Hospital del S.E.S de Mérida
Julián Sánchez Castañón
Hospital de Fuenlabrada
Santiago Prieto Menchero
Mª Isabel García Arata