Overview of HIV molecular epidemiology among people who inject drugs in Europe and Asia

Abstract

HIV strains continuously evolve, tend to recombine and new circulating variants are being discovered. Novel strains complicate efforts to develop a vaccine against HIV and may exhibit higher transmission efficiency and virulence, and elevated resistance to antiretroviral agents. The United Nations Joint Programme on HIV/AIDS (UNAIDS) set an ambitious goal to end HIV as a public health threat by 2030 through comprehensive strategies that include epidemiological input as the first step of the process. In this context, molecular epidemiology becomes invaluable as it captures trends in HIV evolution rates that shape epidemiological pictures across several geographical areas. This review briefly summarizes the molecular epidemiology of HIV among people who inject drugs (PWID) in Europe and Asia. Following high transmission rates of subtype G and CRF14_BG among PWID in Portugal and Spain, two European countries, Greece and Romania, experienced recent HIV outbreaks in PWID that consisted of multiple transmission clusters including subtypes B, A, F1 and recombinants CRF14_BG and CRF35_AD. The latter was first identified in Afghanistan. Russia, Ukraine and other Former Soviet Union (FSU) states are still facing the devastating effects of epidemics in PWID produced by AFSU (also known as IDU-A), BFSU (known as IDU-B), and CRF03_AB. In Asia, CRF01_AE and subtype B (Western B and Thai B) travelled from PWID in Thailand to neighboring countries. Recombination hotspots in South China, Northern Myanmar, and Malaysia have been generating several intersubtype and inter-CRF recombinants (e.g. CRF07_BC, CRF08_BC, CRF33_01B etc.) increasing the complexity of HIV molecular patterns.

Risk network approaches to locating undiagnosed HIV cases in Odessa, Ukraine

“…This research took place in Odessa, a large city in southern Ukraine, which is one of the areas where injection drug use and then an HIV epidemic began in the 1990s and then spread throughout the country. The HIV epidemic in Odessa, as in Ukraine generally, has been a concentrated one with PWID the key population with the most cases until 2008 . Harm reduction programmes increased in size and effectiveness from 2004 and were showing signs of having leveled the epidemic off , though there are worries that recent social movements and the war in Eastern Ukraine may have reversed this.…”

Cross-Continental Dispersal of Major HIV-1 CRF01_AE Clusters in China

“…However, recent studies have reported the emergence and rapid increase of non-B subtypes in various populations globally (Cuevas et al, 2009;Liao et al, 2009;Hawke et al, 2013;Neogi et al, 2014;Beloukas et al, 2016;Nikolopoulos et al, 2016;Dennis et al, 2017), especially among men who have sex with men (MSM) in China (Zhang et al, 2015). CRF01_AE, CRF_BC and Subtype B/B' are most prevalent in Mainland China (Su et al, 2014), and CRF01_AE has recently replaced subtype B as the dominant circulating subtype among Chinese MSM (Zhang et al, 2015).…”

Addressing antiretroviral therapy-related diagnostic coverage gaps across South Africa using a programmatic approach

“… 1 , 2 It is estimated that 36.7 million people globally were living with HIV in 2016, with a prevalence of 0.8%, of which 25.5 million people live in sub-Saharan Africa (~70% of the global HIV burden). 3 , 4 In South Africa, it is estimated that seven million people are living with HIV, with an adult prevalence rate of 19.2% in 2015. 4 , 5 Despite many obstacles faced by South Africa between 2010 and 2014, the response to the AIDS epidemic resulted in the largest antiretroviral treatment (ART) programme in the world, with over two million HIV-infected people receiving treatment by 2010.…”