The HIV-1 Subtype C Epidemic in South America is Linked to the United Kingdom

Authors: de Oliveira T, Pillay D, Gifford RJ; for the UK Collaborative Group on HIV Drug Resistance.
Title: The HIV-1 Subtype C Epidemic in South America is Linked to the United Kingdom
Journal: PLoS One,19;5(2):e9311 (2010)

Reference: de Oliveira T, Pillay D, Gifford RJ; for the UK Collaborative Group on HIV Drug Resistance. The HIV-1 Subtype C Epidemic in South America is Linked to the United Kingdom PLoS One,19;5(2):e9311 (2010).

Citation details*

Journal Impact Factor (I.F.): 4.411
Number of citations: 17

*Sources: Thompson I.F. & Google Scholar (Jan 2012)

Abstract

Background: The global spread of HIV-1 has been accompanied by the emergence of genetically distinct viral strains. Over the past two decades subtype C viruses, which predominate in Southern and Eastern Africa, have spread rapidly throughout parts of South America. Phylogenetic studies indicate that subtype C viruses were introduced to South America through a single founder event that occurred in Southern Brazil. However, the external route via which subtype C viruses spread to the South American continent has remained unclear.

Methodology/Principal Findings: We used automated genotyping to screen 8,309 HIV-1 subtype C pol gene sequences sampled within the UK for isolates genetically linked to the subtype C epidemic in South America. Maximum likelihood and Bayesian approaches were used to explore the phylogenetic relationships between 54 sequences identified in this screen, and a set of globally sampled subtype C reference sequences. Phylogenetic trees disclosed a robustly supported relationship between sequences from Brazil, the UK and East Africa. A monophyletic cluster comprised exclusively of sequences from the UK and Brazil was identified and dated to approximately the early 1980s using a Bayesian coalescent- based method. A sub-cluster of 27 sequences isolated from homosexual men of UK origin was also identified and dated to the early 1990s.

Conclusions: Phylogenetic, demographic and temporal data support the conclusion that the UK was a crucial staging post in the spread of subtype C from East Africa to South America. This unexpected finding demonstrates the role of diffuse international networks in the global spread of HIV-1 infection, and the utility of globally sampled viral sequence data in revealing these networks. Additionally, we show that subtype C viruses are spreading within the UK amongst men who have sex with men.

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