Identification of a large, fast-expanding HIV-1 subtype B transmission cluster among MSM in Valencia, Spain.
We describe and characterize an exceptionally large HIV-1 subtype B transmission cluster occurring in the Comunidad Valenciana (CV, Spain). A total of 1806 HIV-1 protease-reverse transcriptase (PR/RT) sequences from different patients were obtained in the CV between 2004 and 2014. After subtyping and generating a phylogenetic tree with additional HIV-1 subtype B sequences, a very large transmission cluster which included almost exclusively sequences from the CV was detected (n = 143 patients). This cluster was then validated and characterized with further maximum-likelihood phylogenetic analyses and Bayesian coalescent reconstructions. With these analyses, the CV cluster was delimited to 113 patients, predominately men who have sex with men (MSM). Although it was significantly located in the city of Valencia (n = 105), phylogenetic analyses suggested this cluster derives from a larger HIV lineage affecting other Spanish localities (n = 194). Coalescent analyses estimated its expansion in Valencia to have started between 1998 and 2004. From 2004 to 2009, members of this cluster represented only 1.46% of the HIV-1 subtype B samples studied in Valencia (n = 5/143), whereas from 2010 onwards its prevalence raised to 12.64% (n = 100/791). In conclusion, we have detected a very large transmission cluster in the CV where it has experienced a very fast growth in the recent years in the city of Valencia, thus contributing significantly to the HIV epidemic in this locality. Its transmission efficiency evidences shortcomings in HIV control measures in Spain and particularly in Valencia.
Unidad Mixta Infección y Salud Pública FISABIO-CSISP / Universidad de Valencia and CIBER Epidemiología y Salud Pública, Valencia, Spain.
Juan Ángel
JÁ
Patiño-Galindo
Unidad Mixta Infección y Salud Pública FISABIO-CSISP / Universidad de Valencia and CIBER Epidemiología y Salud Pública, Valencia, Spain.
Manoli
M
Torres-Puente
Unidad Mixta Infección y Salud Pública FISABIO-CSISP / Universidad de Valencia and CIBER Epidemiología y Salud Pública, Valencia, Spain.
María Alma
MA
Bracho
Unidad Prevención del SIDA y otras ITS, Valencia, Spain.
Ignacio
I
Alastrué
Unidad Prevención del SIDA y otras ITS, Valencia, Spain.
Amparo
A
Juan
Hospital Clínico Universitario-Universidad de Valencia, Valencia, Spain.
David
D
Navarro
Hospital Clínico Universitario-Universidad de Valencia, Valencia, Spain.
María José
MJ
Galindo
Hospital General Universitario, Valencia, Spain.
Concepción
C
Gimeno
Hospital General Universitario, Valencia, Spain.
Enrique
E
Ortega
Unidad Mixta Infección y Salud Pública FISABIO-CSISP / Universidad de Valencia and CIBER Epidemiología y Salud Pública, Valencia, Spain.
Fernando
http://orcid.org/0000-0002-0879-5798
F
González-Candelas
D024882:Drug Resistance, Viral / Q000187:drug effects / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000472:pathogenicity; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D010802:Phylogeny; D013030:Spain / Q000453:epidemiology; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000235:genetics
D054302:pol Gene Products, Human Immunodeficiency Virus; C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase; D016333:HIV Protease; C514803:p16 protease, Human immunodeficiency virus 1