Distribution and time trends of HIV-1 variants in Poland: Characteristics of non-B clades and recombinant viruses

作者：Parczewski Milosz; Leszczyszyn Pynka Magdalena; Witak Jedra Magdalena; Rymer Weronika; Zalewska Malgorzata; Gasiorowski Jacek; Bociaga Jasik Monika; Kalinowska Nowak Anna; Garlicki Aleksander; Grzeszczuk Anna; Jankowska Maria; Lemanska Malgorzata; Baralkiewicz Grazyna; Mozer Lisewska Iwona; Lojewski Wladyslaw; Grabczewska Edyta; Olczak Anita; Jablonowska Elzbieta; Urbanska Anna

来源：Infection, Genetics and Evolution, 2016, 39: 232-240.

DOI：10.1016/j.meegid.2016.02.001

• Recombination
• HIV subtypes
• Phylogeny

The spread of HIV-1 subtypes varies considerably both worldwide and within Europe, with non-B variants commonly found across various exposure groups. This study aimed to analyse the distribution and temporal trends in HIV-1 subtype variability across Poland. For analysis of the subtype distribution, 1219 partial pol sequences obtained from patients followed up in 9 of 17 Polish HIV treatment centres were used. Subtyping was inferred using the maximum likelihood method; recombination was assessed using the bootscanning and jumping profile hidden Markov model methods. Subtype B dominated in the studied group (n = 1059, 86.9%); in 160 (13.1%) sequences, non-B variants were present [A1 (n = 63, 5.2%), D (n = 43, 3.5%), C (n = 22, 1.8%), and F1 (n = 2, 0.2%)]. In 25 (2.1%) cases circulating recombinant forms (CRFs) were found. Five A1 variants (0.4%) were unique AB recombinant forms (URF) not previously identified in Poland. Non-B clades were notably more common among females (n = 73, 45.6%, p < 0.001) and heterosexual individuals (n = 103, 66.5%, p < 0.001) and less frequent among men who have sex with men (MSM) (n = 27, 17.42%, p < 0.001). HIV-1 viral load at diagnosis was higher among non-B cases [median: 5.0 (IQR: 4.4-5.6)] vs. [median: 4.8 (IQR: 4.3-5.4) log copies/ml for subtype B (p < 0.001)] with a lower CD4(+) lymphocyte count at baseline [median: 248 (IQR: 75-503) for non-B vs. median: 320 (IQR: 125-497) cells/mu l for subtype B; p < 0.001]. The frequency of the non-B subtypes proved stable from 2008 (11.5%) to 2014 (8.0%) [OR: 0.95 (95% CI: 0.84-1.07), p = 0.4], with no temporal differences for exposure groups, gender, age and AIDS. Despite the predominance of subtype B, the variability of HIV in Poland is notable; both CRFs and URFs are present in the analysed population. Non-B variants are associated with heterosexual transmission, more advanced HIV disease and have stable temporal frequencies.

• 出版日期2016-4