title: HIV epidemiology in the Northwestern Federal District of Russia: dominance of HIV type 1 subtype A.
abstract: A rapidly advancing epidemic of HIV-1 infection has been documented among injecting drug users (IDUs) in Russia. The Northwestern Federal District was the first of the seven Russian Federal Districts involved in a drug-related HIV epidemic through an outbreak in Kaliningrad in 1996. The Northwestern Federal District has a high HIV prevalence rate having reached 252 per 100,000 by the end of 2003, exceeding the Russian average (180) by 1.4 times. The epidemic peaked in 2001. Since then the annual number of new cases has decreased, probably reflecting saturation among at least some IDU populations. However, at the same time, the heterosexual spread of HIV has become more prominent. To study the genetic epidemiology of HIV-1, samples were collected from 150 individuals covering a wide geographical area and different transmission groups in the Northwestern Federal District. Phylogenetic analysis revealed that an Eastern European subtype A HIV-1 strain similar to those reported earlier among IDUs in other regions of Russia accounted for 80% of HIV-1 infections and was the predominant subtype in six out of seven administrative territories studied both among IDUs and heterosexually infected persons. As an exception to the dominant role of the Eastern European subtype A strain, the CRF03-AB strain was found to be dominant in the city of Cherepovets located in the north central European Russian territory of Vologda Oblast. This is the first report of the CRF03-AB strain causing an outbreak outside the Kaliningrad region.
authors.affiliation: North-West District AIDS Centre of Russian Federation, Saint-Petersburg Pasteur Institute, Saint-Petersburg, Russia.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Smolskaya
authors.forename: Kirsi
authors.initials: K
authors.lastname: Liitsola
authors.forename: Veera
authors.initials: V
authors.lastname: Zetterberg
authors.forename: Elena
authors.initials: E
authors.lastname: Golovanova
authors.forename: Natalia
authors.initials: N
authors.lastname: Kevlova
authors.forename: Nadezda
authors.initials: N
authors.lastname: Konovalova
authors.forename: Ksenia
authors.initials: K
authors.lastname: Sevastianova
authors.forename: Henrikki
authors.initials: H
authors.lastname: Brummer-Korvenkontio
authors.forename: Mika
authors.initials: M
authors.lastname: Salminen
mesh_terms: D004196:Disease Outbreaks; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics*; D006801:Humans; D008969:Molecular Sequence Data; D012426:Russia / Q000453:epidemiology