Author/Authors :
Azadmanesh Kayhan نويسنده , Bahrampour Abbas نويسنده Professor of biostatistics, Department of biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran , Zolala Farzaneh نويسنده Regional Knowledge Hub for HIV/ AIDS Surveillance, Biostatistics and Epidemiology Department, Kerman University of Medical Sciences , Haghdoost Ali Akbar نويسنده Research Center for Modeling of Health, Kerman University of Medical Sciences, Kerman , Mostafavi Ehsan نويسنده Department of Epidemiology, Pasteur institute of Iran, Tehran, IR Iran , Eybpoosh Sana نويسنده Department of Psychiatry, Tehran University of Medical Sciences. Tehran, Iran. Eybpoosh Sana
Abstract :
Background The origins and spatio-temporal dynamics of the HIV-1
subtype B and CRF01_AE clades are largely unknown in Iran. Objectives
This study investigates the origins and spatio-temporal dynamics of
HIV-1 subtype B and CRF01_AE clades in Iran using the most recent
phylogeographic methods. Methods This Bayesian phylogeographic study
examined HIV-1 sequence data available in the Los Alamos HIV databases.
For the purposes of this study, we retrieved all the eligible
time-stamped and geo-referenced HIV-1 subtype B (pol p66 and p51 RT) and
CRF01_AE (gp160) sequences from Iran. The majority of these data were
obtained from studies using convenience and snowball sampling.
Evolutionary and phylogeographic parameters were jointly estimated for
each clade using BEAST software v.1.8.1. A Bayesian stochastic search
variable selection method, with a threshold of 3.0 for the Bayes factors
test, was used to obtain significant migration rates of the virus.
Results Our results suggest that the subtype B epidemic was introduced
to Iran from Southern China, Germany and the USA. Although the migration
rate from the USA to Iran was found to be statistically insignificant,
the results suggested that the USA was the earliest exporter of the
subtype B to Iran (i.e. since 1974, 95% Highest Posterior Density (HPD):
1966-1974). Moreover, based on our findings, the CRF01_AE clade was
first introduced to Iran from Thailand (1988, 95% HPD: 1986 - 1990).
Among the factors contributing to the transmission of subtype B to Iran
from Germany is the transit of goods and long-distance truck driving.
However, the factors behind the transmission of this clade from the USA
and Southern China remain unknown. Similar to many countries, the
introduction of CRF01_AE from Thailand might be attributed to sex
tourism. Conclusions There is evidence to suggest that subtype B and
CRF01_AE were introduced to Iran through multiple pathways and origins,
including Germany, Southern China, the USA, and Thailand. Factors such
as international trade, the transit of goods, and tourism are among the
most likely methods for transmission of these clades. However, the
existing preventive strategies in Iran have been mostly focused on other
risk groups, including sex workers and intravenous drug users. The
findings of our study highlight the need for the further development of
targeted preventive strategies, such as educational interventions, aimed
at tourists, truck drivers, and people involved in international trade
and transactions in order to prevent the onward transmission of disease.
