Identification of a large, fast-expanding HIV-1 subtype B transmission cluster among MSM in Valencia, Spain

PLoS One. 2017 Feb 2;12(2):e0171062. doi: 10.1371/journal.pone.0171062. eCollection 2017.

Abstract

We describe and characterize an exceptionally large HIV-1 subtype B transmission cluster occurring in the Comunidad Valenciana (CV, Spain). A total of 1806 HIV-1 protease-reverse transcriptase (PR/RT) sequences from different patients were obtained in the CV between 2004 and 2014. After subtyping and generating a phylogenetic tree with additional HIV-1 subtype B sequences, a very large transmission cluster which included almost exclusively sequences from the CV was detected (n = 143 patients). This cluster was then validated and characterized with further maximum-likelihood phylogenetic analyses and Bayesian coalescent reconstructions. With these analyses, the CV cluster was delimited to 113 patients, predominately men who have sex with men (MSM). Although it was significantly located in the city of Valencia (n = 105), phylogenetic analyses suggested this cluster derives from a larger HIV lineage affecting other Spanish localities (n = 194). Coalescent analyses estimated its expansion in Valencia to have started between 1998 and 2004. From 2004 to 2009, members of this cluster represented only 1.46% of the HIV-1 subtype B samples studied in Valencia (n = 5/143), whereas from 2010 onwards its prevalence raised to 12.64% (n = 100/791). In conclusion, we have detected a very large transmission cluster in the CV where it has experienced a very fast growth in the recent years in the city of Valencia, thus contributing significantly to the HIV epidemic in this locality. Its transmission efficiency evidences shortcomings in HIV control measures in Spain and particularly in Valencia.

MeSH terms

  • Drug Resistance, Viral / drug effects
  • Drug Resistance, Viral / genetics
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • HIV Infections / virology
  • HIV Protease / genetics
  • HIV Reverse Transcriptase / genetics
  • HIV-1 / drug effects
  • HIV-1 / genetics*
  • HIV-1 / pathogenicity
  • Homosexuality, Male
  • Humans
  • Male
  • Phylogeny
  • Spain / epidemiology
  • pol Gene Products, Human Immunodeficiency Virus / genetics

Substances

  • pol Gene Products, Human Immunodeficiency Virus
  • reverse transcriptase, Human immunodeficiency virus 1
  • HIV Reverse Transcriptase
  • HIV Protease
  • p16 protease, Human immunodeficiency virus 1

Grants and funding

This work was partly supported by project BFU2014- 58565-R from Ministerio de Economía y Competitividad (Spanish Government) to FGC, project CP07/00078 from Ministerio de Sanidad y Consumo (Spanish Government) to MAB, and Gilead Science SL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.