title: HIV-1 diversity in Romania.
abstract: OBJECTIVE
  To evaluate the prevalence and the dynamics of HIV-1 subtypes in Romanian adults and children, and to investigate the origins of the nosocomial epidemic.
  
  
  METHODS
  A total of 1000 serum and plasma samples, from adults (n = 579) and children (n = 421) who were diagnosed as being HIV-1-infected during 1990-1997 in 39 of the 41 Romanian districts, were serotyped. Viral DNA was isolated from blood samples of 84 patients and the viruses were genotyped.
  
  
  METHODS
  Serotyping was performed with a peptide subtype-specific enzyme immunoassay (SSEIA), based on in vitro competition for antibody binding between the representative V3 peptides of the different clades (A-F). Proviral HIV-1 DNA was genotyped by heteroduplex mobility assay or by sequence analysis of the C2-V3 env region.
  
  
  RESULTS
  SSEIA showed that 93% of the samples from horizontally infected children were serotype F, 1% were serotype B, and the remaining 6% were uninterpretable. In vertically infected children, 74% of strains were serotype F, 10% were serotype A, 3% were serotype B, and 3% were serotype E. Serotype F was also the dominant subtype in adults (68%), but serotypes A, B, C, D and E were also detected. SSEIA gave indeterminate results in 7% of cases. A strong correlation (90%) between serotyping and genotyping for subtype F was found. Analysis of the relative incidence of the different serotypes over a 7-year period (1990-1997) showed a stable distribution.
  
  
  CONCLUSIONS
  Subtype F largely dominates the epidemiology of HIV-1 infection in both children and adults in Romania, although other major subtypes are present. The predominance of subtype F in Romania may be a future potential source of HIV-1 variability in Europe.
authors.affiliation: Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Apetrei
authors.forename: A
authors.initials: A
authors.lastname: Necula
authors.forename: C
authors.initials: C
authors.lastname: Holm-Hansen
authors.forename: I
authors.initials: I
authors.lastname: Loussert-Ajaka
authors.forename: I
authors.initials: I
authors.lastname: Pandrea
authors.forename: C
authors.initials: C
authors.lastname: Cozmei
authors.forename: A
authors.initials: A
authors.lastname: Streinu-Cercel
authors.forename: F R
authors.initials: FR
authors.lastname: Pascu
authors.forename: E
authors.initials: E
authors.lastname: Negut
authors.forename: G
authors.initials: G
authors.lastname: Molnar
authors.forename: M
authors.initials: M
authors.lastname: Duca
authors.forename: M
authors.initials: M
authors.lastname: Pecec
authors.forename: F
authors.initials: F
authors.lastname: Brun-Vézinet
authors.forename: F
authors.initials: F
authors.lastname: Simon
mesh_terms: D000328:Adult; D000595:Amino Acid Sequence; D002648:Child; D014644:Genetic Variation; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008969:Molecular Sequence Data; D012383:Romania / Q000453:epidemiology; D012703:Serotyping