@article {10869,
	title = {Molecular characterization of HIV-1 infection in Northwest Spain (2009-2013): Investigation of the subtype F outbreak.},
	journal = {Infect Genet Evol},
	volume = {30},
	year = {2015},
	month = {2015 Mar},
	pages = {96-101},
	abstract = {BACKGROUND: HIV-1 subtype B is the predominant one in European regions several, while other subtypes and recombinants are also circulating with high prevalence. A sub-epidemic of subtype F with specific characteristics and low response to treatment has been recently identified in Galicia. In this study we investigated the characteristics of the HIV-1 subtype F sub-epidemic in A Coru{\~n}a and Santiago de Compostela in Northwest Spain.

METHODS: 420 newly HIV-1 diagnosed patients during 2009-2013 were enrolled in this study. HIV-1 subtyping was carried out using automated subtyping tools and phylogenetic analysis. Molecular epidemiology investigation of subtypes B and F was performed by means of phylogenetic analysis using fast maximum likelihood. Phylodynamic analysis was performed using Bayesian method as implemented in BEAST v1.8.

RESULTS: Subtype B found to be the predominant (61.2\% and 70.4\%) followed by subtype F (25.6\% and 12.0\%) in both areas (A Coru{\~n}a and Santiago de Compostela, respectively). The latter found to mainly spread among men having sex with men (MSM). The vast majority of subtype F lineages from both areas clustered monophyletically, while subtype B sequences clustered in several tree branches. The exponential growth of subtype F sub-epidemic dated back in 2008 by means of phylodynamic analysis. Most of new infections during 2009-2013 occurred within the subtype F transmission cluster.

CONCLUSIONS: Subtype F circulates at high prevalence in A Coru{\~n}a and Santiago de Compostela in Northwest Spain, suggesting that the HIV-1 epidemic in this region has distinct characteristics to the rest of Spain. Subtype F has being spreading among MSM and is currently the most actively spreading network. The single cluster spread of this local sub-epidemic might provide an explanation for the distinct characteristics and the low response to antiretroviral treatment.},
	keywords = {Adult, Disease Outbreaks, Female, HIV Infections, HIV-1, Humans, Male, Middle Aged, molecular epidemiology, Phylogeny, Spain},
	issn = {1567-7257},
	doi = {10.1016/j.meegid.2014.12.012},
	author = {Paraskevis, Dimitrios and Kostaki, Evangelia and Beloukas, Apostolos and Ca{\~n}izares, Angelina and Aguilera, Antonio and Rodr{\'\i}guez, Javier and Grandal, Marta and Pernas, Berta and Castro-Iglesias, Angeles and Mena, {\'A}lvaro and Pedreira, Jos{\'e} D and Poveda, Eva}
}
