1. The HIV Type 1 Epidemic in Bulgaria Involves Multiple Subtypes and Is Sustained by Continuous Viral Inflow from West and East European Countries
- Author
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Tsvetana Yakimova, Marco Salemi, Stefania Montieri, Tonka Varleva, Massimo Ciccozzi, Tulio de Oliveira, Ivailo Elenkov, Danail Beshkov, Giovanni Rezza, Maria Mercedes Santoro, Maureen M. Goodenow, Ivan Elenkov, and Ivailo Alexiev
- Subjects
Adult ,Gene Flow ,Male ,Time Factors ,Epidemiology ,Immunology ,Molecular Sequence Data ,HIV Infections ,Biology ,Disease Outbreaks ,Cohort Studies ,Phylogenetics ,Virology ,Genetic variation ,Humans ,Molecular clock ,Bulgaria ,Phylogeny ,Genetics ,Genetic diversity ,Likelihood Functions ,Molecular Epidemiology ,Molecular epidemiology ,Phylogenetic tree ,Base Sequence ,Genetic heterogeneity ,Sequence Analysis, RNA ,Genetic Variation ,Bayes Theorem ,Emigration and Immigration ,Eastern european ,Infectious Diseases ,pol Gene Products, Human Immunodeficiency Virus ,HIV-1 ,RNA, Viral ,Female ,Monte Carlo Method ,Sequence Alignment - Abstract
Little is known about the HIV-1 epidemic in Balkan countries. To fill the gap, we investigated the viral genetic diversity in Bulgaria, by sequencing and phylogenetic characterization of 86 plasma samples collected between 2002 and 2006 from seropositive individuals diagnosed within 1986-2006. Analysis of pol gene sequences assigned 51% of the samples to HIV-1 subtype B and 27% to subtype A1. HIV-1 subtype C, F, G, H, and a few putative recombinant forms were also found. Phylogenetic and molecular clock analysis showed a continuous exchange of subtype A and B between Bulgaria and Western as well as other Eastern European countries. At least three separate introductions of HIV-1 subtype A and four of HIV-1 subtype B have occurred within the past 25 years in Bulgaria. The central geographic location of Bulgaria, the substantial genetic heterogeneity of the epidemic with multiple subtypes, and the significant viral flow observed to and from the Balkan countries have the potential to modify the current HIV-1 epidemiological structure in Europe and highlight the importance of more extensive and continuous monitoring of the epidemic in the Balkans.
- Published
- 2008