title: Two Independent HIV Epidemics in Saint Petersburg, Russia Revealed by Molecular Epidemiology.
abstract: The HIV epidemic in Russia, one of the world's fastest growing, has been concentrated mostly among people who inject drugs (PWID). We sought to explore the epidemiology of the epidemic in St. Petersburg by sampling from the highest risk groups of PWID and men who have sex with men (MSM) and use viral sequencing data to better understand the nature of the city's epidemic. Serological testing confirmed an HIV prevalence among PWID in excess of 40%. All but 1 of 110 PWID whose blood samples were tested for genetic diversity were infected by subtype A virus, specifically by the AFSU strain. The remaining person was infected with a CRF-06cpx recombinant. Analysis of pairwise genetic distance among all PWID studied revealed an average of 3.1% sequence divergence, suggesting clonal introduction of the AFSU strain and/or constraints on sequence divergence. The HIV prevalence was less than 10% among MSM. All 17 sequences from HIV-infected MSM were found to be a clade B virus with a much higher average sequence diversity of 15.7%. These findings suggest two independent epidemics with little overlap between the two highest at-risk populations, which will require different HIV prevention approaches.
authors.affiliation: 1The Biomedical Center, Saint Petersburg, Russian Federation.|2Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Elena
authors.initials: E
authors.lastname: Dukhovlinova
authors.affiliation: 1The Biomedical Center, Saint Petersburg, Russian Federation.
authors.forename: Alexey
authors.initials: A
authors.lastname: Masharsky
authors.affiliation: 1The Biomedical Center, Saint Petersburg, Russian Federation.
authors.forename: Olga
authors.initials: O
authors.lastname: Toussova
authors.affiliation: 1The Biomedical Center, Saint Petersburg, Russian Federation.|3Saint Petersburg State Polytechnical University, Saint Petersburg, Russian Federation.
authors.forename: Sergei
authors.initials: S
authors.lastname: Verevochkin
authors.affiliation: 1The Biomedical Center, Saint Petersburg, Russian Federation.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Solovyeva
authors.affiliation: 1The Biomedical Center, Saint Petersburg, Russian Federation.
authors.forename: Maria
authors.initials: M
authors.lastname: Meringof
authors.affiliation: 4School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Elijah
authors.initials: E
authors.lastname: Paintsil
authors.affiliation: 5School of Public Health, Yale University, New Haven, Connecticut.
authors.forename: Edward
authors.initials: E
authors.lastname: White
authors.affiliation: 5School of Public Health, Yale University, New Haven, Connecticut.
authors.forename: Russell
authors.initials: R
authors.lastname: Barbour
authors.affiliation: 5School of Public Health, Yale University, New Haven, Connecticut.
authors.forename: Robert
authors.initials: R
authors.lastname: Heimer
authors.affiliation: 1The Biomedical Center, Saint Petersburg, Russian Federation.|3Saint Petersburg State Polytechnical University, Saint Petersburg, Russian Federation.
authors.forename: Andrei
authors.initials: A
authors.lastname: Kozlov
mesh_terms: D000293:Adolescent; D000328:Adult; D058872:Epidemics; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006678:HIV / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D012426:Russia / Q000453:epidemiology; D017422:Sequence Analysis, DNA; D015819:Substance Abuse, Intravenous / Q000150:complications; D055815:Young Adult