title: Global Dispersal Pattern of HIV Type 1 Subtype CRF01_AE: A Genetic Trace of Human Mobility Related to Heterosexual Sexual Activities Centralized in Southeast Asia.
abstract: BACKGROUND
  Human immunodeficiency virus type 1 (HIV-1) subtype CRF01_AE originated in Africa and then passed to Thailand, where it established a major epidemic. Despite the global presence of CRF01_AE, little is known about its subsequent dispersal pattern.
  
  
  METHODS
  We assembled a global data set of 2736 CRF01_AE sequences by pooling sequences from public databases and patient-cohort studies. We estimated viral dispersal patterns, using statistical phylogeographic analysis run over bootstrap trees estimated by the maximum likelihood method.
  
  
  RESULTS
  We show that Thailand has been the source of viral dispersal to most areas worldwide, including 17 of 20 sampled countries in Europe. Japan, Singapore, Vietnam, and other Asian countries have played a secondary role in the viral dissemination. In contrast, China and Taiwan have mainly imported strains from neighboring Asian countries, North America, and Africa without any significant viral exportation.
  
  
  CONCLUSIONS
  The central role of Thailand in the global spread of CRF01_AE can be probably explained by the popularity of Thailand as a vacation destination characterized by sex tourism and by Thai emigration to the Western world. Our study highlights the unique case of CRF01_AE, the only globally distributed non-B clade whose global dispersal did not originate in Africa.
authors.affiliation: Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, University of Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Angelis
authors.affiliation: Department of Microbiology, Tumor, and Cell Biology Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Albert
authors.affiliation: Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, University of Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mamais
authors.affiliation: Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, University of Athens, Greece Department of Zoology, University of Oxford, United Kingdom.
authors.forename: Gkikas
authors.initials: G
authors.lastname: Magiorkinis
authors.affiliation: Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, University of Athens, Greece.
authors.forename: Angelos
authors.initials: A
authors.lastname: Hatzakis
authors.affiliation: Robert Koch-Institut, Berlin, Germany.
authors.forename: Osamah
authors.initials: O
authors.lastname: Hamouda
authors.affiliation: Centre de Recherche Public de la Sante, Luxembourg.
authors.forename: Daniel
authors.initials: D
authors.lastname: Struck
authors.affiliation: Clinical and Epidemiological Virology, Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Belgium.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Vercauteren
authors.affiliation: Department of Virology, University Medical Center, Utrecht.
authors.forename: Annemarie M J
authors.initials: AM
authors.lastname: Wensing
authors.affiliation: National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.
authors.forename: Ivailo
authors.initials: I
authors.lastname: Alexiev
authors.affiliation: University of Bergen, Norway.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Åsjö
authors.affiliation: University of Milan, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Balotta
authors.affiliation: Centro de Malária e OutrasDoenças Tropicais and Unidade de Microbiologia, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal.
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Camacho
authors.affiliation: University College Dublin, Ireland.
authors.forename: Suzie
authors.initials: S
authors.lastname: Coughlan
authors.affiliation: Lithuanian AIDS Center, Vilnius.
authors.forename: Algirdas
authors.initials: A
authors.lastname: Griskevicius
authors.affiliation: Tel Aviv University, Israel.
authors.forename: Zehava
authors.initials: Z
authors.lastname: Grossman
authors.affiliation: Hospital of Infectious Diseases, Warsaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Horban
authors.affiliation: University of Cyprus, Nicosia.
authors.forename: Leondios G
authors.initials: LG
authors.lastname: Kostrikis
authors.affiliation: Department of Molecular Diagnostics and Flow Cytometry, University Hospital for Infectious Diseases Dr F. Mihaljevic, Zagreb, Croatia.
authors.forename: Snjezana
authors.initials: S
authors.lastname: Lepej
authors.affiliation: National Institute of Health and Welfare, Helsinki, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Liitsola
authors.affiliation: National Reference Laboratory of AIDS, National Institute of Health, Prague, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Linka
authors.affiliation: Statens Serum Institute, Copenhagen, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Nielsen
authors.affiliation: National Institute for Infectious Diseases Prof Dr Matei Bals, Bucharest, Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Otelea
authors.affiliation: IrsiCaixa Foundation, Badalona, Spain.
authors.forename: Roger
authors.initials: R
authors.lastname: Paredes
authors.affiliation: Faculty of Medicine, Slovenian HIV/AIDS Reference Center, University of Ljubljana, Slovenia.
authors.forename: Mario
authors.initials: M
authors.lastname: Poljak
authors.affiliation: Division of Infectious Diseases Division of Clinical Virology, Karolinska Institute.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Puchhammer-Stöckl
authors.affiliation: Centre de Recherche Public de la Sante, Luxembourg.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Schmit
authors.affiliation: Division of Infectious Diseases Division of Clinical Virology, Karolinska Institute Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Sönnerborg
authors.affiliation: Slovak Medical University, Bratislava.
authors.forename: Danica
authors.initials: D
authors.lastname: Staneková
authors.affiliation: University of Belgrade Faculty of Medicine, Serbia.
authors.forename: Maja
authors.initials: M
authors.lastname: Stanojevic
authors.affiliation: Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Charles A B
authors.initials: CA
authors.lastname: Boucher
authors.affiliation: Alcohol Research Group, University California, Berkeley.
authors.forename: Lauren
authors.initials: L
authors.lastname: Kaplan
authors.affiliation: Clinical and Epidemiological Virology, Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Belgium Centro de Malária e OutrasDoenças Tropicais and Unidade de Microbiologia, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal.
authors.forename: Anne-Mieke
authors.initials: AM
authors.lastname: Vandamme
authors.affiliation: Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, University of Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Paraskevis
mesh_terms: D001210:Asia, Southeastern; D016000:Cluster Analysis; D016208:Databases, Factual; D005060:Europe; D015658:HIV Infections / Q000635:transmission* / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics*; D020010:Heterosexuality; D006801:Humans; D010802:Phylogeny; D058974:Phylogeography; D011157:Population Dynamics
keywords: CRF01_AE; HIV-1; dispersal pattern; migration; phylogeography