AEGiS-14IAC: Molecular epidemiology and evolution of the HIV epidemic in Finland: effect of an outbreak among IDU in 1998.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Molecular epidemiology and evolution of the HIV epidemic in Finland: effect of an outbreak among IDU in 1998.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. A10039)

Salminen MO, Liitsola K, Holmstrom P, Brummer-Korvenkontio H, Ristola M, Sutinen J, Suni J, Zetterberg V, Leinikki P
National Public Health Institute, Mannerheimintie 166, FIN-00300, Helsinki, Finland

BACKGROUND: In Finland, the incidence of reported HIV-1 infection associated with injecting drug use (IDU) remained very low until 1998. An outbreak among IDU in 1998 has almost doubled the yearly incidence of all reported cases. We showed earlier that the outbreak is caused by a point-source introduction of the CRF01-AE strain prevalent in South East Asia. The contribution of the IDU outbreak to the epidemic of sexually transmitted cases was studied.

METHODS: Plasma samples from newly reported cases were prospectively collected from more than 50% of all annually reported cases since 1999 and analyzed for viral subtype and variability. The gag p7 and env V3 regions were RT-PCR amplified and directly sequenced for phylogenetic subtype analysis and determination of genetic variation. Epidemiological data (probable mode of transmission) was collected from physicians notifications. [Image not included]

RESULTS: Subtypes A, B, C, CRF01-AE and G were found to contribute to the Finnish HIV-1 epidemic. Large differences between categories of probable mode of transmission were found. Among cases reported as associated to sex between men, almost exclusively subtype B was found. CRF01-AE dominated among IDU-associated cases. Among cases reported to be heterosexually transmitted, multiple subtypes were found, and cases were approximately equally divided between subtype B and other subtypes. Subtype C was the non-B subtypes most frequently found in this category. Genetic variation was relatively high, except for among IDU-associated cases. Few cases of CRF01-AE were found among sexual-transmission associated infections.

CONCLUSIONS: The HIV-1 epidemic in Finland is highly heterogenous. Molecular data suggests that sexually acquired cases are mostly unlinked, and there is no indication of large scale spread of the CRF01-AE epidemic to the sexual transmission category. Among IDU, genetic variability remains low, but shows signs of diversification.

Keywords: AEGIS, HIV Infections, Epidemiology, Molecular, HIV-1, Disease Outbreaks, Evolution, HIV Seropositivity, Phylogeny, Variation (Genetics), HIV-1 Reverse Transcriptase, Finland, Asia, Southeastern, Human, Male, epidemiology, geneticsKWDaegis,hivinfections,epidemiology,molecular,hiv-1,diseaseoutbreaks,evolution,hivseropositivity,phylogeny,variation(genetics),hiv-1reversetranscriptase,finland,asia,southeastern,human,male,epidemiology,genetics

020707
A10039

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