PLoS ONE
Volume 10, Issue 8, 2015

A population-structured HIV epidemic in Israel: Roles of risk and ethnicity (Article) (Open Access)

Grossman Z. , Avidor B. , Mor Z. , Chowers M. , Levy I. , Shaha E. , Riesenberg K. , Sthoeger Z. , Maayan S. , Shao W. , Lorber M. , Olstein-Pops K. , Elbirt D. , Elinav H. , Asher I. , Averbuch D. , Istomin V. , Gottesman B.S. , Kedem E. , Girshengorn S. , Kra-Oz Z. , Avni Y.S. , Sade S.R. , Turner D. , Maldarelli F.
  • a School of Public Health, Tel-Aviv University, Tel-Aviv, Israel, National Cancer Institute, Frederick, MD, United States
  • b Crusaid Kobler AIDS Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Laboratory of Viruses and Molecular Biology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
  • c Ramla Department of Health, Ministry of Health, Ramla, Israel
  • d Meir Medical Center, Kfar Saba, Israel
  • e Infectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel
  • f Rambam Medical Center, Haifa, Israel
  • g Soroka Medical Center, Beer-Sheva, Israel
  • h Kaplan Medical Center, Rehovot, Israel
  • i Hadassah Medical Center, Jerusalem, Israel
  • j Advanced Biomedical Computing Center, SAICFrederick, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21702, United States
  • k Rambam Medical Center, Haifa, Israel
  • l Hadassah Medical Center, Jerusalem, Israel
  • m Kaplan Medical Center, Rehovot, Israel
  • n Hadassah Medical Center, Jerusalem, Israel
  • o Kaplan Medical Center, Rehovot, Israel
  • p Hadassah Medical Center, Jerusalem, Israel
  • q Hillel Yaffe Medical Center, Hadera, Israel
  • r Meir Medical Center, Kfar Saba, Israel
  • s Rambam Medical Center, Haifa, Israel
  • t Crusaid Kobler AIDS Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Laboratory of Viruses and Molecular Biology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
  • u Rambam Medical Center, Haifa, Israel
  • v Soroka Medical Center, Beer-Sheva, Israel
  • w Kaplan Medical Center, Rehovot, Israel
  • x Crusaid Kobler AIDS Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
  • y National Cancer Institute, Frederick, MD, United States

Abstract

Background: HIV in Israel started with a subtype-B epidemic among men who have sex with men, followed in the 1980s and 1990s by introductions of subtype C from Ethiopia (predominantly acquired by heterosexual transmission) and subtype A from the former Soviet Union (FSU, most often acquired by intravenous drug use). The epidemic matured over the last 15 years without additional large influx of exogenous infections. Between 2005 and 2013 the number of infected men who have sex with men (MSM) increased 2.9-fold, compared to 1.6-fold and 1.3-fold for intravenous drug users (IVDU) and Ethiopian-origin residents. Understanding contemporary spread is essential for effective public health planning. Methods: We analyzed demographic and virologic data from 1,427 HIV-infected individuals diagnosed with HIV-I during 1998-2012. HIV phylogenies were reconstructed with maximumlikelihood and Bayesian methods. Results: Subtype-B viruses, but not A or C, demonstrated a striking number of large clusters with common ancestors having posterior probability ≥0.95, including some suggesting presence of transmission networks. Transmitted drug resistance was highest in subtype B (13%). MSM represented a frequent risk factor in cross-ethnic transmission, demonstrated by the presence of Israeli-born with non-B virus infections and FSU immigrants with non-A subtypes. Conclusions: Reconstructed phylogenetic trees demonstrated substantial grouping in subtype B, but not in non-MSM subtype-A or in subtype-C, reflecting differences in transmission dynamics linked to HIV transmission categories. Cross-ethnic spread occurred through multiple independent introductions, with MSM playing a prevalent role in the transmission of the virus. Such data provide a baseline to track epidemic trends and will be useful in informing and quantifying efforts to reduce HIV transmission. © This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Author Keywords

[No Keywords available]

Index Keywords

genetics HIV Infections transmission Israel Human immunodeficiency virus infection demography complication virus strain human risk assessment middle aged statistics and numerical data controlled study Aged population structure substance abuse virus identification nonhuman ethnology Human immunodeficiency virus men who have sex with men Homosexuality, Male male homosexuality Epidemics Young Adult Humans virology Adolescent Infant, Newborn male preschool child Aged, 80 and over Infant very elderly risk factor Bayes theorem Risk Factors Child, Preschool newborn female syndrome delineation Article epidemic Ethiopia Substance Abuse, Intravenous major clinical study Phylogeny adult Infectious Disease Transmission, Vertical HIV-1 infection risk Human immunodeficiency virus 1 virus transmission vertical transmission ethnicity molecular phylogeny Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84942920801&doi=10.1371%2fjournal.pone.0135061&partnerID=40&md5=4a234029bb3041d70f36e2fee2ec4daf
DOI: 10.1371/journal.pone.0135061
ISSN: 19326203
Cited by: 6
Original Language: English