title: Limited cross-border infections in patients newly diagnosed with HIV in Europe.
abstract: BACKGROUND
  International travel plays a role in the spread of HIV-1 across Europe. It is, however, not known whether international travel is more important for spread of the epidemic as compared to endogenous infections within single countries. In this study, phylogenetic associations among HIV of newly diagnosed patients were determined across Europe.
  
  
  RESULTS
  Data came from the SPREAD programme which collects samples of newly diagnosed patients that are representative for national HIV epidemics. 4260 pol sequences from 25 European countries and Israel collected in 2002-2007 were included.We identified 457 clusters including 1330 persons (31.2% of all patients). The cluster size ranged between 2 and 28. A number of 987 patients (74.2%) were part of a cluster that consisted only of patients originating from the same country. In addition, 135 patients (10.2%) were in a cluster including only individuals from neighboring countries. Finally, 208 patients (15.6%) clustered with individuals from countries without a common border. Clustering with patients from the same country was less prevalent in patients being infected with B subtype (P-value <0.0001), in men who have sex with men (P-value <0.0001), and in recently infected patients (P-value =0.045).
  
  
  CONCLUSIONS
  Our findings indicate that the transmission of HIV-1 in Europe is predominantly occurring between patients from the same country. This could have implications for HIV-1 transmission prevention programmes. Because infections through travelling between countries is not frequently observed it is important to have good surveillance of the national HIV-1 epidemics.
authors.affiliation: Department of Virology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Dineke
authors.initials: D
authors.lastname: Frentz
authors.forename: Annemarie M J
authors.initials: AM
authors.lastname: Wensing
authors.forename: Jan
authors.initials: J
authors.lastname: Albert
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Paraskevis
authors.forename: Ana B
authors.initials: AB
authors.lastname: Abecasis
authors.forename: Osamah
authors.initials: O
authors.lastname: Hamouda
authors.forename: Louise B
authors.initials: LB
authors.lastname: Jørgensen
authors.forename: Claudia
authors.initials: C
authors.lastname: Kücherer
authors.forename: Daniel
authors.initials: D
authors.lastname: Struck
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Schmit
authors.forename: Birgitta
authors.initials: B
authors.lastname: Åsjö
authors.forename: Claudia
authors.initials: C
authors.lastname: Balotta
authors.forename: Danail
authors.initials: D
authors.lastname: Beshkov
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Camacho
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Clotet
authors.forename: Suzie
authors.initials: S
authors.lastname: Coughlan
authors.forename: Stéphane
authors.initials: S
authors.lastname: De Wit
authors.forename: Algirdas
authors.initials: A
authors.lastname: Griskevicius
authors.forename: Zehava
authors.initials: Z
authors.lastname: Grossman
authors.forename: Andrzej
authors.initials: A
authors.lastname: Horban
authors.forename: Tatjana
authors.initials: T
authors.lastname: Kolupajeva
authors.forename: Klaus
authors.initials: K
authors.lastname: Korn
authors.forename: Leondios G
authors.initials: LG
authors.lastname: Kostrikis
authors.forename: Kirsi
authors.initials: K
authors.lastname: Liitsola
authors.forename: Marek
authors.initials: M
authors.lastname: Linka
authors.forename: Claus
authors.initials: C
authors.lastname: Nielsen
authors.forename: Dan
authors.initials: D
authors.lastname: Otelea
authors.forename: Roger
authors.initials: R
authors.lastname: Paredes
authors.forename: Mario
authors.initials: M
authors.lastname: Poljak
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Puchhammer-Stöckl
authors.forename: Anders
authors.initials: A
authors.lastname: Sönnerborg
authors.forename: Danica
authors.initials: D
authors.lastname: Stanekova
authors.forename: Maja
authors.initials: M
authors.lastname: Stanojevic
authors.forename: Anne-Mieke
authors.initials: AM
authors.lastname: Vandamme
authors.forename: Charles A B
authors.initials: CA
authors.lastname: Boucher
authors.forename: David A M C
authors.initials: DA
authors.lastname: Van de Vijver
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D005060:Europe / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics*; D017422:Sequence Analysis, DNA; D014195:Travel
chemical_list: D012367:RNA, Viral
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