ArticlePloS one2016
HIV-1 A1 Subtype Epidemic in Italy Originated from Africa and Eastern Europe and Shows a High Frequency of Transmission Chains Involving Intravenous Drug Users.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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18 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Prevalence and spatiotemporal dynamics of HIV-1 Circulating Recombinant Form 03_AB (CRF03_AB) in the Former Soviet Union countries.PloS one · 2020Pooled it
- The Molecular Epidemiology of HIV-1 in Russia, 1987-2023: Subtypes, Transmission Networks and Phylogenetic Story.Pathogens (Basel, Switzerland) · 2025Article
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- Molecular epidemiology and HIV-1 variant evolution in Poland between 2015 and 2019.Scientific reports · 2021Article
- Molecular Epidemiological Analysis of the Origin and Transmission Dynamics of the HIV-1 CRF01_AE Sub-Epidemic in Bulgaria.Viruses · 2021Article
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- High HIV-1 diversity in immigrants resident in Italy (2008-2017).Scientific reports · 2020Article
- Prevalence of Non-B HIV-1 Subtypes in North Italy and Analysis of Transmission Clusters Based on Sequence Data Analysis.Microorganisms · 2019Article
- Reconstruction of the Genetic History and the Current Spread of HIV-1 Subtype A in Germany.Journal of virology · 2019Article
- Characterization of a large cluster of HIV-1 A1 infections detected in Portugal and connected to several Western European countries.Scientific reports · 2019Article
- Local Epidemics Gone Viral: Evolution and Diffusion of the Italian HIV-1 Recombinant Form CRF60_BC.Frontiers in microbiology · 2019Article
- Diverse Large HIV-1 Non-subtype B Clusters Are Spreading Among Men Who Have Sex With Men in Spain.Frontiers in microbiology · 2019Article
- Age of HIV Acquisition Affects the Risk of Multi-Morbidity after 25 Years of Infection Exposure.The Journal of frailty & aging · 2019Article
- Overview of HIV molecular epidemiology among people who inject drugs in Europe and Asia.Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases · 2016Review
- Factors Driving the HIV Epidemic in Southern Africa.Current HIV/AIDS reports · 2016Review
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSubtype A accounts for only 12% of HIV-1 infections worldwide but predominates in Russia and Former Soviet Union countries of Eastern Europe. After an early propagation via heterosexual contacts, this variant spread explosively among intravenous drug users. A distinct A1 variant predominates in Greece and Albania, which penetrated directly from Africa. Clade A1 accounts for 12.5% of non-B subtypes in Italy, being the most frequent after F1 subtype.
aimAim of this study was to investigate the circulation of A1 subtype in Italy and trace its origin and diffusion through phylogenetic and phylodynamic approaches.
resultsThe phylogenetic analysis of 113 A1 pol sequences included in the Italian ARCA database, indicated that 71 patients (62.8%) clustered within 5 clades. A higher probability to be detected in clusters was found for patients from Eastern Europe and Italy (88.9% and 60.4%, respectively) compared to those from Africa (20%) (p < .001). Higher proportions of clustering sequences were found in intravenous drug users with respect to heterosexuals (85.7% vs. 59.3%, p = .056) and in women with respect to men (81.4% vs. 53.2%, p < .006). Subtype A1 dated phylogeny indicated an East African origin around 1961. Phylogeographical reconstruction highlighted 3 significant groups. One involved East European and some Italian variants, the second encompassed some Italian and African strains, the latter included the majority of viruses carried by African and Italian subjects and all viral sequences from Albania and Greece.
conclusionsSubtype A1 originated in Central Africa and spread among East European countries in 1982. It entered Italy through three introduction events: directly from East Africa, from Albania and Greece, and from the area encompassing Moldavia and Ukraine. As in previously documented A1 epidemics of East European countries, HIV-1 A1 subtype spread in Italy in part through intravenous drug users. However, Eastern European women contributed to the penetration of such variant, probably through sex work.
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