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Wagner T, Zuckerman NS, Wax M, Shirazi R, Gozlan Y, Girshengorn S, Marom R, Mendelson E, Turner D, Mor O. HIV-1 Circulating Recombinant Forms (CRFs) and Unique Recombinant Forms (URFs) in Israel, 2010-2018. Viruses 2022; 14:v14091970. [PMID: 36146776 PMCID: PMC9502407 DOI: 10.3390/v14091970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
Monitoring HIV-1 circulating recombinant forms (CRFs) and unique recombinant forms (URFs) is important for disease surveillance. Recombination may affect prevention efforts and interfere with the diagnosis and treatment of HIV-1 infection. Here, we characterized the epidemiology of HIV-1 CRFs and URFs in Israel. Partial pol sequences from treatment naïve patients diagnosed in 2010−2018 were assessed using the recombinant identification program (RIP), the recombinant detection program (RDP5), and using the maximum-likelihood phylogenetic method, using 410 reference sequences obtained from the Los Alamos database. CRFs and URFs were identified in 11% (213/1940) of all sequenced cases. The median age at diagnosis was 38 (30−47) years, 61% originated from Israel, and 82% were male. The most common were CRF02_AG (30.5%), CRF01_AE (16.9%), and the more complex forms CRF01_AE/CRF02_AG/A3 (10.8%) and B/F1 (7%). A significant increase in their overall proportion was observed in recent years (8.1% in 2010−2012, 20.3% in 2016−2018, p < 0.001). This increase was most prominent in individuals carrying CRF02_AG (2.5% in 2010−2015, 9.8% in 2016−2018, p < 0.001). Men who have sex with men (MSM) was the most common risk group; however, those infected with the secondary recombinant CRF02_AG/A6 were mainly injecting drug users (IDUs). The most common resistance mutations were K103N (5/213, 2.3%) and E138A (18/213, 8.5%) in the reverse transcriptase. Only E138A was more frequent in the recombinants compared with the classic subtypes and was significantly associated with a specific secondary CRF, CRF02_AG/A4. We concluded that CRFs and URFs were mainly detected in Israeli-born MSM and that an increase in the overall proportion of such HIV-1 sequences could be observed in more recent years.
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Affiliation(s)
- Tali Wagner
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan 5262112, Israel
- Correspondence: (T.W.); (O.M.); Tel.: +972-3-5302458 (T.W. & O.M.)
| | - Neta S. Zuckerman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan 5262112, Israel
| | - Marina Wax
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan 5262112, Israel
| | - Rachel Shirazi
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan 5262112, Israel
| | - Yael Gozlan
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan 5262112, Israel
| | - Shirley Girshengorn
- Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel
| | - Rotem Marom
- Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel
| | - Ella Mendelson
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan 5262112, Israel
| | - Dan Turner
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel
| | - Orna Mor
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan 5262112, Israel
- Correspondence: (T.W.); (O.M.); Tel.: +972-3-5302458 (T.W. & O.M.)
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Wagner T, Zuckerman NS, Halperin T, Chemtob D, Levy I, Elbirt D, Shachar E, Olshtain-Pops K, Elinav H, Chowers M, Itsomin V, Riesenberg K, Wax M, Shirazi R, Gozlan Y, Matus N, Girshengorn S, Marom R, Mendelson E, Turner D, Mor O. Epidemiology and Transmitted HIV-1 Drug Resistance among Treatment-Naïve Individuals in Israel, 2010-2018. Viruses 2021; 14:v14010071. [PMID: 35062274 PMCID: PMC8779053 DOI: 10.3390/v14010071] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 01/22/2023] Open
Abstract
Despite the low prevalence of HIV-1 in Israel, continuous waves of immigration may have impacted the local epidemic. We characterized all people diagnosed with HIV-1 in Israel in 2010–2018. The demographics and clinical data of all individuals (n = 3639) newly diagnosed with HIV-1 were retrieved. Subtypes, transmitted drug-resistance mutations (TDRM), and phylogenetic relations, were determined in >50% of them. In 39.1%, HIV-1 transmission was through heterosexual contact; 34.3% were men who have sex with men (MSM); and 10.4% were people who inject drugs. Many (>65%) were immigrants. Israeli-born individuals were mostly (78.3%) MSM, whereas only 9% of those born in Sub-Saharan Africa (SSA), Eastern Europe and Central Asia (EEU/CA), were MSM. The proportion of individuals from SSA decreased through the years 2010–2018 (21.1% in 2010–2012; 16.8% in 2016–2018) whereas those from EEU/CA increased significantly (21% in 2010–2012; 27.8% in 2016–2018, p < 0.001). TDRM were identified in 12.1%; 3.7, 3.3 and 6.6% had protease inhibitors (PI), nucleotide reverse transcriptase inhibitors (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI) TDRM, respectively, with the overall proportion remaining stable in the studied years. None had integrase TDRM. Subtype B was present in 43.9%, subtype A in 25.2% (A6 in 22.8 and A1 in 2.4%) and subtype C in 17.1% of individuals. Most MSM had subtype B. Subtype C carriers formed small clusters (with one unexpected MSM cluster), A1 formed a cluster mainly of locally-born patients with NNRTI mutations, and A6 formed a looser cluster of individuals mainly from EEU. Israelis, <50 years old, carrying A1, had the highest risk for having TDRM. In conclusion, an increase in immigrants from EEU/CA and a decrease in those from SSA characterized the HIV-1 epidemic in 2010–2018. Baseline resistance testing should still be recommended to identify TDRM, and improve surveillance and care.
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Affiliation(s)
- Tali Wagner
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; (T.W.); (I.L.); (M.C.); (E.M.); (D.T.)
- Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel; (N.S.Z.); (M.W.); (R.S.); (Y.G.)
| | - Neta S. Zuckerman
- Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel; (N.S.Z.); (M.W.); (R.S.); (Y.G.)
| | - Tami Halperin
- Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel; (T.H.); (N.M.); (S.G.); (R.M.)
| | - Daniel Chemtob
- Faculty of Medicine, Braun School of Public Health & Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem 9112102, Israel; (D.C.); (D.E.); (H.E.)
- Tuberculosis and AIDS Department, Ministry of Health, Jerusalem 9101002, Israel
| | - Itzchak Levy
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; (T.W.); (I.L.); (M.C.); (E.M.); (D.T.)
- Chaim Sheba Medical Center, Infectious Disease Unit, Ramat Gan 5262112, Israel
| | - Daniel Elbirt
- Faculty of Medicine, Braun School of Public Health & Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem 9112102, Israel; (D.C.); (D.E.); (H.E.)
- Immunology, Kaplan Medical Center, Rehovot 76100, Israel
| | - Eduardo Shachar
- Immunology Unit, Rambam Health Care Campus, Haifa 3109601, Israel;
- Rappaport Faculty of Medicine, Institute of Technology, Technion, Haifa 3200003, Israel
| | | | - Hila Elinav
- Faculty of Medicine, Braun School of Public Health & Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem 9112102, Israel; (D.C.); (D.E.); (H.E.)
- Hadassah Medical Center, Jerusalem 9112102, Israel;
| | - Michal Chowers
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; (T.W.); (I.L.); (M.C.); (E.M.); (D.T.)
- Infectious Diseases, Meir Medical Center, Kfar Saba 4428164, Israel
| | | | - Klaris Riesenberg
- Faculty of Health Sciences, Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
- Soroka Medical Center, Infectious Disease Institute, Beer-Sheva 84101, Israel
| | - Marina Wax
- Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel; (N.S.Z.); (M.W.); (R.S.); (Y.G.)
| | - Rachel Shirazi
- Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel; (N.S.Z.); (M.W.); (R.S.); (Y.G.)
| | - Yael Gozlan
- Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel; (N.S.Z.); (M.W.); (R.S.); (Y.G.)
| | - Natasha Matus
- Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel; (T.H.); (N.M.); (S.G.); (R.M.)
| | - Shirley Girshengorn
- Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel; (T.H.); (N.M.); (S.G.); (R.M.)
| | - Rotem Marom
- Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel; (T.H.); (N.M.); (S.G.); (R.M.)
| | - Ella Mendelson
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; (T.W.); (I.L.); (M.C.); (E.M.); (D.T.)
- Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel; (N.S.Z.); (M.W.); (R.S.); (Y.G.)
| | - Dan Turner
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; (T.W.); (I.L.); (M.C.); (E.M.); (D.T.)
- Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel; (T.H.); (N.M.); (S.G.); (R.M.)
| | - Orna Mor
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; (T.W.); (I.L.); (M.C.); (E.M.); (D.T.)
- Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel; (N.S.Z.); (M.W.); (R.S.); (Y.G.)
- Correspondence: ; Tel.: +972-3-530-2458
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Lee JE, Lee SO, Lee S, Park S, Kim HH, Shin KH, Kang JS, Lee SH. Epidemiological and phylogenetic analysis for non-B subtypes of human immunodeficiency virus type 1 in Busan, Korea. Sci Rep 2021; 11:16000. [PMID: 34362954 PMCID: PMC8346492 DOI: 10.1038/s41598-021-94794-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/18/2021] [Indexed: 11/29/2022] Open
Abstract
Recent data on non-B subtypes’ epidemiology among patients infected with human immunodeficiency virus-1 (HIV-1) in Korea are lacking. We aimed to assess the changing trends in the epidemiology of non-B subtypes of HIV-1 in Korea using phyloepidemiological analyses. We analyzed the demographic records and sequencing data obtained from genotypic drug resistance tests between 2005 and 2019 from 517 patients infected with HIV attending a tertiary care hospital in Busan, Korea. Subtyping and phylogenetic analyses with reference sequences were performed. Additionally, transmission clusters were identified via maximum-likelihood trees. Non-B subtypes accounted for 21.3% of the 517 sequences. CRF01_AE (52.7%) was the most common non-B subtype, followed by CRF02_AG (16.4%), A1 (11.8%), and C (5.5%). The prevalence of non-B subtypes decreased from 36.4 to 13.4% by 2009, while it increased to 27.4% between 2015 and 2019. Among patients with non-B subtypes, the proportion of overseas sailors decreased from 66.7 to 7.5%; contrarily, the proportion of men-who-have-sex-with-men (MSM) increased from 0 to 46.9% over the study period. We identified 8 transmission clusters involving non-B subtypes, with sizes ranging from 2 to 4 patients, including 3 clusters containing MSM. Our results highlight the changes in the epidemiological trends of non-B subtypes of HIV-1 in Korea.
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Affiliation(s)
- Jeong Eun Lee
- Division of Infectious Disease, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea
| | - Soon Ok Lee
- Division of Infectious Disease, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea
| | - Shinwon Lee
- Division of Infectious Disease, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea
| | - Sohee Park
- Division of Infectious Disease, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea
| | - Hyung-Hoi Kim
- Deparment of Laboratory Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Informatics Unit, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Kyung-Hwa Shin
- Deparment of Laboratory Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jin Suk Kang
- Division of Infectious Disease, Department of Internal Medicine, Inje University College of Medicine, Busan, Republic of Korea
| | - Sun Hee Lee
- Division of Infectious Disease, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea.
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