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Angeletti S, Lo Presti A, Giovanetti M, Grifoni A, Amicosante M, Ciotti M, Alcantara LCJ, Cella E, Ciccozzi M. Phylogenesys and homology modeling in Zika virus epidemic: food for thought. Pathog Glob Health 2016; 110:269-274. [PMID: 27670692 DOI: 10.1080/20477724.2016.1235337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Zika virus (ZIKV) is an emerging Flavivirus that have recently caused an outbreak in Brazil and rapid spread in several countries. In this study, the consequences of ZIKV evolution on protein recognition by the host immune system have been analyzed. Evolutionary analysis was combined with homology modeling and T-B cells epitope predictions. Two separate clades, the African one with the Uganda sequence, as the most probable ancestor, and the second one containing all the most recent sequences from the equatorial belt were identified. Brazilian strains clustered all together and closely related to the French Polynesia isolates. A strong presence of a negatively selected site in the envelope gene (Env) protein was evidenced, suggesting a probable purging of deleterious polymorphisms in functionally important genes. Our results show relative conservancy of ZIKV sequences when envelope and other non-structural proteins (NS3 and NS5) are analyzed by homology modeling. However, some regions within the consensus sequence of NS5 protein and to a lesser extent in the envelope protein, show localized high mutation frequency corresponding to a considerable alteration in protein stability. In terms of viral immune escape, envelope protein is under a higher selective pressure than NS5 and NS3 proteins for HLA class I and II molecules. Moreover, envelope mutations that are not strictly related to T-cell immune responses are mostly located on the surface of the protein in putative B-cell epitopes, suggesting an important contribution of B cells in the immune response as well.
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Affiliation(s)
- Silvia Angeletti
- a Unit of Clinical Pathology and Microbiology , University Campus Bio-Medico , Rome , Italy
| | - Alessandra Lo Presti
- b Department of Infectious, Parasitic, and Immune-Mediated Diseases, Epidemiology Unit, Reference Centre on Phylogeny, Molecular Epidemiology, and Microbial Evolution (FEMEM) , National Institute of Health , Rome , Italy
| | - Marta Giovanetti
- c Oswaldo Cruz Foundation (FIOCRUZ) , Salvador , Brazil.,d Department of Biology , University of Rome 'Tor Vergata' , Rome , Italy
| | | | - Massimo Amicosante
- e ProxAgen Ltd , Sofia , Bulgaria.,f Department of Biomedicine and Prevention , University of Rome "Tor Vergata" , Rome , Italy
| | - Marco Ciotti
- g Laboratory of Molecular Virology , Polyclinic Tor Vergata Foundation , Rome , Italy
| | | | - Eleonora Cella
- b Department of Infectious, Parasitic, and Immune-Mediated Diseases, Epidemiology Unit, Reference Centre on Phylogeny, Molecular Epidemiology, and Microbial Evolution (FEMEM) , National Institute of Health , Rome , Italy.,h Department of Public Health and Infectious Diseases , Sapienza University of Rome , Rome , Italy
| | - Massimo Ciccozzi
- a Unit of Clinical Pathology and Microbiology , University Campus Bio-Medico , Rome , Italy.,b Department of Infectious, Parasitic, and Immune-Mediated Diseases, Epidemiology Unit, Reference Centre on Phylogeny, Molecular Epidemiology, and Microbial Evolution (FEMEM) , National Institute of Health , Rome , Italy
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Beloukas A, Psarris A, Giannelou P, Kostaki E, Hatzakis A, Paraskevis D. Molecular epidemiology of HIV-1 infection in Europe: An overview. INFECTION GENETICS AND EVOLUTION 2016; 46:180-189. [PMID: 27321440 DOI: 10.1016/j.meegid.2016.06.033] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 12/19/2022]
Abstract
Human Immunodeficiency Virus type 1 (HIV-1) is characterised by vast genetic diversity. Globally circulating HIV-1 viruses are classified into distinct phylogenetic strains (subtypes, sub-subtypes) and several recombinant forms. Here we describe the characteristics and evolution of European HIV-1 epidemic over time through a review of published literature and updated queries of existing HIV-1 sequence databases. HIV-1 in Western and Central Europe was introduced in the early-1980s in the form of subtype B, which is still the predominant clade. However, in Eastern Europe (Former Soviet Union (FSU) countries and Russia) the predominant strain, introduced into Ukraine in the mid-1990s, is subtype A (AFSU) with transmission mostly occurring in People Who Inject Drugs (PWID). In recent years, the epidemic is evolving towards a complex tapestry with an increase in the prevalence of non-B subtypes and recombinants in Western and Central Europe. Non-B epidemics are mainly associated with immigrants, heterosexuals and females but more recently, non-B clades have also spread amongst groups where non-B strains were previously absent - non-immigrant European populations and amongst men having sex with men (MSM). In some countries, non-B clades have spread amongst the native population, for example subtype G in Portugal and subtype A in Greece, Albania and Cyprus. Romania provides a unique case where sub-subtype F1 has predominated throughout the epidemic. In contrast, HIV-1 epidemic in FSU countries remains more homogeneous with AFSU clade predominating in all countries. The differences between the evolution of the Western epidemic and the Eastern epidemic may be attributable to differences in transmission risk behaviours, lifestyle and the patterns of human mobility. The study of HIV-1 epidemic diversity provides a useful tool by which we can understand the history of the pandemic in addition to allowing us to monitor the spread and growth of the epidemic over time.
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Affiliation(s)
- Apostolos Beloukas
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Institute of Infection & Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Alexandros Psarris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Polina Giannelou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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3
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Giovanetti M, Milano T, Alcantara LC, Carcangiu L, Cella E, Lai A, Lo Presti A, Pascarella S, Zehender G, Angeletti S, Ciccozzi M. Zika Virus spreading in South America: Evolutionary analysis of emerging neutralizing resistant Phe279Ser strains. ASIAN PAC J TROP MED 2016; 9:445-52. [PMID: 27261852 DOI: 10.1016/j.apjtm.2016.03.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/16/2016] [Accepted: 03/15/2016] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To investigate the genetic diversity of Zika Virus (ZIKV) and the relationships existing among these circulating viruses worldwide. To evaluate the genetic polymorphisms harbored from ZIKV that can have an influence on the virus circulation. METHODS Three different ZIKV dataset were built. The first dataset included 63 E gene sequences, the second one 22 NS3 sequences and the third dataset was composed of 108 NS5 gene sequences. Phylogenetic and selective pressure analysis was performed. The edited nucleic acid alignment from the Envelope dataset was used to generate a conceptual translation to the corresponding peptide sequences through UGene software. RESULTS The phylogeographic reconstruction was able to discriminate unambiguously that the Brazilian strains are belonged to the Asian lineage. The structural analysis reveals instead the presence of the Ser residue in the Brazilian sequences (however already observed in other previously reported ZIKV infections) that could suggest the presence of a neutralization-resistant population of viruses. CONCLUSIONS Phylogenetic, evolutionary and selective pressure analysis contributed to improve the knowledge on the circulation of ZIKV.
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Affiliation(s)
- Marta Giovanetti
- Department of Infectious Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy; Department of Biology, University of Rome 'Tor Vergata', Rome, Italy; Laboratory of Hematology, Genetic and Computational Biology, Gonçalo Moniz Research Center, Oswaldo Cruz Foundation (LHGB/CPqGM/FIOCRUZ), Salvador, Bahia, Brazil
| | - Teresa Milano
- Dipartimento di Scienze Biochimiche 'A. Rossi Fanelli', Università La Sapienza, 00185 Roma, Italy
| | - Luiz Carlos Alcantara
- Laboratory of Hematology, Genetic and Computational Biology, Gonçalo Moniz Research Center, Oswaldo Cruz Foundation (LHGB/CPqGM/FIOCRUZ), Salvador, Bahia, Brazil
| | - Laura Carcangiu
- Department of Infectious Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy
| | - Eleonora Cella
- Department of Infectious Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessia Lai
- Laboratory of Infectious Diseases and Tropical Medicine, University of Milan, Italy
| | - Alessandra Lo Presti
- Department of Infectious Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy
| | - Stefano Pascarella
- Dipartimento di Scienze Biochimiche 'A. Rossi Fanelli', Università La Sapienza, 00185 Roma, Italy
| | | | - Silvia Angeletti
- Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy
| | - Massimo Ciccozzi
- Department of Infectious Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy; University Campus Bio-Medico, Rome, Italy.
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Lo Presti A, Cella E, Giovanetti M, Lai A, Angeletti S, Zehender G, Ciccozzi M. Origin and evolution of Nipah virus. J Med Virol 2015; 88:380-8. [PMID: 26252523 DOI: 10.1002/jmv.24345] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 01/22/2023]
Abstract
Nipah virus, member of the Paramyxoviridae family, is classified as a Biosafety Level-4 agent and category C priority pathogen. Nipah virus disease is endemic in south Asia and outbreaks have been reported in Malaysia, Singapore, India, and Bangladesh. Bats of the genus Pteropus appear to be the natural reservoir of this virus. The aim of this study was to investigate the genetic diversity of Nipah virus, to estimate the date of origin and the spread of the infection. The mean value of Nipah virus N gene evolutionary rate, was 6.5 × 10(-4) substitution/site/year (95% HPD: 2.3 × 10(-4)-1.18 × 10(-3)). The time-scaled phylogenetic analysis showed that the root of the tree originated in 1947 (95% HPD: 1888-1988) as the virus entered in south eastern Asiatic regions. The segregation of sequences in two main clades (I and II) indicating that Nipah virus had two different introductions: one in 1995 (95% HPD: 1985-2002) which correspond to clade I, and the other in 1985 (95% HPD: 1971-1996) which correspond to clade II. The phylogeographic reconstruction indicated that the epidemic followed two different routes spreading to the other locations. The trade of infected pigs may have played a role in the spread of the virus. Bats of the Pteropus genus, that are able to travel to long distances, may have contributed to the spread of the infection. Negatively selected sites, statistically supported, could reflect the stability of the viral N protein.
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Affiliation(s)
- Alessandra Lo Presti
- Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanità, Rome, Italy
| | - Eleonora Cella
- Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanità, Rome, Italy.,Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Marta Giovanetti
- Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanità, Rome, Italy.,Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Alessia Lai
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Section of Infectious Diseases and Immonupathology, University of Milan, Milan, Italy
| | - Silvia Angeletti
- Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy
| | - Gianguglielmo Zehender
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Section of Infectious Diseases and Immonupathology, University of Milan, Milan, Italy
| | - Massimo Ciccozzi
- Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanità, Rome, Italy.,University Hospital Campus Bio-Medico, Rome, Italy
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5
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Milano T, Contestabile R, Lo Presti A, Ciccozzi M, Pascarella S. The aspartate aminotransferase-like domain of Firmicutes MocR transcriptional regulators. Comput Biol Chem 2015; 58:55-61. [PMID: 26026720 DOI: 10.1016/j.compbiolchem.2015.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 05/09/2015] [Accepted: 05/14/2015] [Indexed: 02/03/2023]
Abstract
Bacterial MocR transcriptional regulators possess an N-terminal DNA-binding domain containing a conserved helix-turn-helix module and an effector-binding and/or oligomerization domain at the C-terminus, homologous to fold type-I pyridoxal 5'-phosphate (PLP) enzymes. Since a comprehensive structural analysis of the MocR regulators is still missing, a comparisons of Firmicutes MocR sequences was undertook to contribute to the understanding of the structural characteristics of the C-terminal domain of these proteins, and to shed light on the structural and functional relationship with fold type-I PLP enzymes. Results of this work suggest the presence of at least three subgroups within the MocR sequences and provide a guide for rational site-directed mutagenesis studies aimed at deciphering the structure-function relationships in this new protein family.
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Affiliation(s)
- Teresa Milano
- Dipartimento di Scienze Biochimiche "A. Rossi Fanelli", Università La Sapienza, 00185 Roma, Italy
| | - Roberto Contestabile
- Dipartimento di Scienze Biochimiche "A. Rossi Fanelli", Università La Sapienza, 00185 Roma, Italy
| | - Alessandra Lo Presti
- Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, 00185 Roma, Italy
| | - Massimo Ciccozzi
- Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, 00185 Roma, Italy
| | - Stefano Pascarella
- Dipartimento di Scienze Biochimiche "A. Rossi Fanelli", Università La Sapienza, 00185 Roma, Italy.
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6
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De Luca A, Di Giambenedetto S, Lo Presti A, Sierra S, Prosperi M, Cella E, Giovanetti M, Torti C, Caudai C, Vicenti I, Saladini F, Almi P, Grima P, Blanc P, Fabbiani M, Rossetti B, Gagliardini R, Kaiser R, Ciccozzi M, Zazzi M. Two Distinct Hepatitis C Virus Genotype 1a Clades Have Different Geographical Distribution and Association With Natural Resistance to NS3 Protease Inhibitors. Open Forum Infect Dis 2015; 2:ofv043. [PMID: 26213689 PMCID: PMC4511743 DOI: 10.1093/ofid/ofv043] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/26/2015] [Indexed: 12/18/2022] Open
Abstract
Background. Hepatitis C virus (HCV) genotype 1 is the most prevalent worldwide. Subtype 1a, compared with 1b, shows lower response rates and higher propensity to select for drug resistance to NS3 and selected NS5A and nonnucleoside NS5B inhibitors. Two distinct clades of subtype 1a have been described. Methods. Using Bayesian methodology, we performed a time-scaled phylogeny reconstruction of clade separation and characterized the geographic distribution, phylodynamics, and association with natural resistance variants of NS3 sequences from 362 patients carrying subtype 1a HCV. Results. All sequences segregated in 2 clearly distinct clades. Clade I showed an earlier origin from the common ancestor compared with clade II. Clade I virus was more prevalent in non-European countries, represented mostly by United States, compared with European (75.7% vs 49.3%; P < .001). The prevalence of the natural NS3 variant Q80K, associated with resistance to the macrocyclic protease inhibitor simeprevir, was detected in 51.6% of clade I and 0% of clade II (P < .001); clade I showed a lower genetic barrier for Q80K, whereas no sign of selective pressure at any protease inhibitor resistance-associated codon was detected. Conclusions. Hepatitis C virus subtype 1a clades have a clearly different distribution in Europe and the United States, and the natural resistance mutation Q80K is exclusively associated with clade I.
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Affiliation(s)
- Andrea De Luca
- Unità Operativa ComplessaMalattie Infettive Universitarie, Siena University Hospital, Italy
- Institute of Clinical Infectious Diseases, Catholic University, Roma, Italy
| | | | | | - Saleta Sierra
- Partner Site of the German Center for Infection Research Deutsches Zentrum für Infektionsforschung; Institute of Virology, University of Cologne, Germany
| | - Mattia Prosperi
- Department of Epidemiology, University of Florida, Gainesville
| | - Eleonora Cella
- Department of Infectious Diseases, National Institute of Health, Roma, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Marta Giovanetti
- Department of Infectious Diseases, National Institute of Health, Roma, Italy
- Department of Biology, University of Rome “Tor Vergata”, Italy
| | - Carlo Torti
- University of Brescia, Italy
- Unit of Infectious Diseases, University “Magna Graecia”, Catanzaro, Italy
| | - Cinzia Caudai
- Department of Medical Biotechnologies, University of Siena, Italy
| | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, Italy
| | | | - Paolo Almi
- Unità Operativa Complessa Malattie Infettive ed Epatologia, Siena University Hospital, Italy
| | - Pierfrancesco Grima
- Infectious Diseases Unit, S. Caterina Novella Hospital, Galatina, Lecce, Italy
| | - Pierluigi Blanc
- Unità Operativa Malattie InfettiveOspedale Santa Maria Annunziata Azienda Sanitaria Locale 10, Firenze, Italy
| | | | - Barbara Rossetti
- Unità Operativa ComplessaMalattie Infettive Universitarie, Siena University Hospital, Italy
| | | | - Rolf Kaiser
- Partner Site of the German Center for Infection Research Deutsches Zentrum für Infektionsforschung; Institute of Virology, University of Cologne, Germany
| | - Massimo Ciccozzi
- Department of Infectious Diseases, National Institute of Health, Roma, Italy
- University Campus-Biomedico, Rome, Italy
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, Italy
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7
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Stanojevic M, Siljic M, Salemovic D, Pesic-Pavlovic I, Zerjav S, Nikolic V, Ranin J, Jevtovic D. Ten years survey of primary HIV-1 resistance in Serbia: the occurrence of multiclass resistance. AIDS Res Hum Retroviruses 2014; 30:634-41. [PMID: 24635515 DOI: 10.1089/aid.2013.0270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In Serbia, the first cases of HIV infection were reported in 1985, whereas antiretroviral (ARV) therapy has been in use since 1987. With this study we aimed to assess the occurrence and pattern of HIV resistance mutations among newly diagnosed patients in the period 2002-2011. The study prospectively included 181 adult patients. Genotypic HIV-1 drug resistance testing was performed and drug resistance was scored according to the 2009 WHO list for surveillance of drug resistance mutations (SDRMs). A bioinformatic approach was used to estimate the duration of infection by calculating the percentage of ambiguous basecalls per sequence, with a cutoff of 0.47% as the delimiter for recent infection. The overall prevalence of transmitted drug resistance (TDR) found in the study was 8.8% (16/181, 95% CI=5.5-13.8). Thirty-one percent of resistant samples contained multiple SDRMs. In particular, 5/16 patients with resistance carried viral strains with SDRMs to multiple ARV classes, hence one-third of resistant strains were multiclass resistant, including non-B strains. A total of 51.9% of samples (94/181) were classified as recent infection, with a significant increase in the second part of the study period. However, the prevalence of TDR in recent infection was 6.4% (6/94, 95% CI=2.9-13.2), not statistically different from that found in nonrecent infection. We showed a changing pattern of TDR mutations over the study period, with a substantial occurrence of multiclass resistance, across different HIV subtypes. Our results highlight the need for continued surveillance of primary resistance.
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Affiliation(s)
- Maja Stanojevic
- Institute of Microbiology and Immunology, University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Marina Siljic
- Institute of Microbiology and Immunology, University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Dubravka Salemovic
- Institute for Infectious and Tropical Diseases CCS, HIV/AIDS Unit, Belgrade, Serbia
| | - Ivana Pesic-Pavlovic
- Institute for Infectious and Tropical Diseases CCS, HIV/AIDS Unit, Belgrade, Serbia
| | - Sonja Zerjav
- Institute for Infectious and Tropical Diseases CCS, HIV/AIDS Unit, Belgrade, Serbia
| | - Valentina Nikolic
- Institute of Microbiology and Immunology, University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Jovan Ranin
- Institute of Microbiology and Immunology, University of Belgrade Faculty of Medicine, Belgrade, Serbia
- Institute for Infectious and Tropical Diseases CCS, HIV/AIDS Unit, Belgrade, Serbia
| | - Djordje Jevtovic
- Institute of Microbiology and Immunology, University of Belgrade Faculty of Medicine, Belgrade, Serbia
- Institute for Infectious and Tropical Diseases CCS, HIV/AIDS Unit, Belgrade, Serbia
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8
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Ciccozzi M, Ciccaglione AR, Lo Presti A, Equestre M, Cella E, Ebranati E, Gabanelli E, Villano U, Bruni R, Yalcinkaya T, Tanzi E, Zehender G. Evolutionary dynamics of HBV-D1 genotype epidemic in Turkey. J Med Virol 2013; 86:109-16. [DOI: 10.1002/jmv.23740] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2013] [Indexed: 12/26/2022]
Affiliation(s)
- Massimo Ciccozzi
- Epidemiology Unit, Department of Infectious, Parasite and Immune-Mediated Diseases; Italian Institute of Health; Rome Italy
| | - Anna Rita Ciccaglione
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Viral Hepatitis Unit; Italian Institute of Health; Rome Italy
| | - Alessandra Lo Presti
- Epidemiology Unit, Department of Infectious, Parasite and Immune-Mediated Diseases; Italian Institute of Health; Rome Italy
| | - Michele Equestre
- Department of Cell Biology and Neurosciences; Italian Institute of Health; Rome Italy
| | - Eleonora Cella
- Epidemiology Unit, Department of Infectious, Parasite and Immune-Mediated Diseases; Italian Institute of Health; Rome Italy
| | - Erika Ebranati
- Department of Biomedical and Clinical Sciences, Infectious Diseases and Immunopathology Section; ‘L. Sacco’ Hospital, University of Milan; Milan Italy
| | - Elena Gabanelli
- Department of Biomedical and Clinical Sciences, Infectious Diseases and Immunopathology Section; ‘L. Sacco’ Hospital, University of Milan; Milan Italy
| | - Umbertina Villano
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Viral Hepatitis Unit; Italian Institute of Health; Rome Italy
| | - Roberto Bruni
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Viral Hepatitis Unit; Italian Institute of Health; Rome Italy
| | | | - Elisabetta Tanzi
- Department of Public Health, Microbiology and Virology; University of Milan; Milano Italy
| | - Gianguglielmo Zehender
- Department of Biomedical and Clinical Sciences, Infectious Diseases and Immunopathology Section; ‘L. Sacco’ Hospital, University of Milan; Milan Italy
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9
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Zehender G, Sorrentino C, Lai A, Ebranati E, Gabanelli E, Lo Presti A, Vujoševic D, Lauševic D, Terzić D, Shkjezi R, Bino S, Vratnica Z, Mugosa B, Galli M, Ciccozzi M. Reconstruction of the evolutionary dynamics of hepatitis C virus subtypes in Montenegro and the Balkan region. INFECTION GENETICS AND EVOLUTION 2013; 17:223-30. [PMID: 23603418 DOI: 10.1016/j.meegid.2013.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/26/2013] [Accepted: 04/03/2013] [Indexed: 12/13/2022]
Abstract
More than 20 million hepatitis C virus (HCV) carriers live in the countries of the Eastern Mediterranean. We determined HCV genotype distribution among chronically infected patients in Montenegro and investigated the phylodynamics and phylogeography of the most represented HCV subtypes. The HCV-NS5b sequences of the Montenegrin patients were compared with sequences isolated in different known localities of the Mediterranean area, Europe and Asia. A Bayesian approach was used in order to allow the simultaneous estimate of the evolutionary rate, time-scaled phylogeny, demography and ancestral spatial status. The most frequent HCV subtypes among the Montenegrin patients, were 1b (34.7%) and 3a (24.7%), but there was also a significant prevalence of 1a and 4d (19.5%). Subtype 3a was significantly more frequent among younger patients and intravenous drug users (IDUs), whereas subtype 1b was more frequently associated with iatrogenic exposure and older ages. The spatio-temporal analysis of the epidemic suggested that HCV-1b penetrated Europe at the beginning of the XX century, probably through Greece and Cyprus and in the 1920s reached Montenegro, where there was an exponential increase in the effective number of infections between the 1950s and 1970s. The phylogeographic and phylodynamic analysis of HCV 3a showed that its most probable origin was in the Indian sub-continent (Pakistan in our reconstruction) about 300years ago. The evolutionary dynamics analysis showed that HCV-3a reached Montenegro more recently in the late 1970s and underwent multi-phasic growth still persisting. Our data suggest multiple introduction of HCV subtypes in the area, supported by different causes of dispersion: adverse social conditions and unsafe medical practices for HCV-1b and i.v. drug use for HCV-3a.
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Affiliation(s)
- Gianguglielmo Zehender
- Department of Biomedical and Clinical Sciences L Sacco, Infectious Diseases and Tropical Medicine Chair, University of Milan, Milan, Italy.
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10
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Ivanov IA, Beshkov D, Shankar A, Hanson DL, Paraskevis D, Georgieva V, Karamacheva L, Taskov H, Varleva T, Elenkov I, Stoicheva M, Nikolova D, Switzer WM. Detailed molecular epidemiologic characterization of HIV-1 infection in Bulgaria reveals broad diversity and evolving phylodynamics. PLoS One 2013; 8:e59666. [PMID: 23527245 PMCID: PMC3602066 DOI: 10.1371/journal.pone.0059666] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 02/20/2013] [Indexed: 11/19/2022] Open
Abstract
Limited information is available to describe the molecular epidemiology of HIV-1 in Bulgaria. To better understand the genetic diversity and the epidemiologic dynamics of HIV-1 we analyzed 125 new polymerase (pol) sequences from Bulgarians diagnosed through 2009 and 77 pol sequences available from our previous study from persons infected prior to 2007. Epidemiologic and demographic information was obtained from each participant and phylogenetic analysis was used to infer HIV-1 evolutionary histories. 120 (59.5%) persons were infected with one of five different HIV-1 subtypes (A1, B, C, F1 and H) and 63 (31.2%) persons were infected with one of six different circulating recombinant forms (CRFs; 01_AE, 02_AG, 04_cpx, 05_DF, 14_BG, and 36_cpx). We also for the first time identified infection with two different clusters of unique A-like and F-like sub-subtype variants in 12 persons (5.9%) and seven unique recombinant forms (3.5%), including a novel J/C recombinant. While subtype B was the major genotype identified and was more prevalent in MSM and increased between 2000–2005, most non-B subtypes were present in persons ≥45 years old. CRF01_AE was the most common non-B subtype and was higher in women and IDUs relative to other risk groups combined. Our results show that HIV-1 infection in Bulgaria reflects the shifting distribution of genotypes coincident with the changing epidemiology of the HIV-1 epidemic among different risk groups. Our data support increased public health interventions targeting IDUs and MSM. Furthermore, the substantial and increasing HIV-1 genetic heterogeneity, combined with fluctuating infection dynamics, highlights the importance of sustained and expanded surveillance to prevent and control HIV-1 infection in Bulgaria.
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Affiliation(s)
- Ivailo Alexiev Ivanov
- National Reference Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.
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11
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Ciccozzi M, Madeddu G, Lo Presti A, Cella E, Giovanetti M, Budroni C, Babudieri S, Mura MS, Zehender G, Salemi M. HIV type 1 origin and transmission dynamics among different risk groups in sardinia: molecular epidemiology within the close boundaries of an Italian island. AIDS Res Hum Retroviruses 2013; 29:404-10. [PMID: 22985362 DOI: 10.1089/aid.2012.0209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In Italy, the HIV-1 epidemic is still mainly sustained by the subtype B genetic form, although other and novel subtypes and circulating recombinant forms (CRFs) have been reported. A total of 215 HIV-1 pol gene sequences were collected between 1992 and 2010. Multiple alignments spanning subtype-specific HIV-1 B pol sequences were analyzed by Bayesian phylogenetic methods. Subtype B represented 90.7% (n=195) of the sequences. Three main clusters were detected. The root of the tree dated to 1987. Most of the observed viral gene flow events occurred from heterosexual to intravenous drug users (IDUs). Phylogenetic and molecular clock analysis showed an early HIV-1 subtype B introduction in the mid-1980s and dissemination within local risk-specific clusters. This is the first study to describe in detail the HIV-1 molecular epidemiology in one of the largest islands in the European basin. The future potential of the Sardinian epidemic as a hub between Southern and Northern Europe has to been considered.
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Affiliation(s)
- Massimo Ciccozzi
- Epidemiology Unit, Department of Infectious, Parasite and Immune-Mediated Diseases, Italian Institute of Health, Rome, Italy
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Alessandra Lo Presti
- Epidemiology Unit, Department of Infectious, Parasite and Immune-Mediated Diseases, Italian Institute of Health, Rome, Italy
| | - Eleonora Cella
- Epidemiology Unit, Department of Infectious, Parasite and Immune-Mediated Diseases, Italian Institute of Health, Rome, Italy
| | - Marta Giovanetti
- Epidemiology Unit, Department of Infectious, Parasite and Immune-Mediated Diseases, Italian Institute of Health, Rome, Italy
| | - Carla Budroni
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Sergio Babudieri
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Maria Stella Mura
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Gianguglielmo Zehender
- Department of Clinical Sciences, L. Sacco Hospital, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy
| | - Marco Salemi
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, Florida
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12
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Grgic I, Lepej SZ, Lunar MM, Poljak M, Vince A, Vrakela IB, Planinic A, Seme K, Begovac J. The prevalence of transmitted drug resistance in newly diagnosed HIV-infected individuals in Croatia: the role of transmission clusters of men who have sex with men carrying the T215S surveillance drug resistance mutation. AIDS Res Hum Retroviruses 2013; 29:329-36. [PMID: 22906365 PMCID: PMC3552172 DOI: 10.1089/aid.2012.0191] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to determine the prevalence of transmitted drug resistance (TDR) in newly diagnosed and treatment-naive HIV-infected patients from Croatia and evaluate a possible contribution of transmission clusters to the spread of resistant virus. The study enrolled treatment-naive HIV-infected patients that entered clinical care at the Croatian Reference Center for HIV/AIDS between 2006 and 2008. The protease gene and a part of the reverse transcriptase gene of the HIV-1 genome were sequenced by using the Trugene HIV-1 Genotyping System. The prevalence of transmitted drug resistance was analyzed by using the surveillance drug resistance mutations (SDRM) list recommended by the WHO in 2009. We report findings for 118 of 180 eligible patients (65.6% coverage). SDRM were detected in 26 of 118 patients (22.0%) who were infected with subtype B and belonged mostly to the men having sex with men (MSM). The majority of patients with primary resistance carried SDRM associated with resistance to nucleoside analogues reverse transcriptase inhibitors (NRTIs, 23 of 118 patients, 19.5%). The most frequently found NRTI SDRM was T215S (17 of 118 patients, 14.4%). SDRM associated with resistance to nonnucleoside reverse transcriptase inhibitors were detected in three (2.5%) patients and primary resistance to protease inhibitors was not detected. Non-B subtypes were detected in 13/118 patients (11%). A total of 12 transmission pairs and eight distinct transmission clusters were identified with the largest cluster harboring sequences from 19 patients; among them all but two were carrying the T215S mutation. This study showed a high prevalence of TDR in newly diagnosed MSM from Croatia and is an important contribution concerning the relationship between local transmission clusters and the spread of resistant virus.
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Affiliation(s)
- Ivana Grgic
- Department of Flow Cytometry and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic,” Zagreb, Croatia
| | - Snjezana Zidovec Lepej
- Department of Flow Cytometry and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic,” Zagreb, Croatia
| | - Maja M. Lunar
- Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Mario Poljak
- Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Adriana Vince
- Department of HIV/AIDS, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic” and University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ivana Baca Vrakela
- Department of Flow Cytometry and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic,” Zagreb, Croatia
| | - Ana Planinic
- Department of Flow Cytometry and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic,” Zagreb, Croatia
| | - Katja Seme
- Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Josip Begovac
- Department of HIV/AIDS, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic” and University of Zagreb School of Medicine, Zagreb, Croatia
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13
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Ciccozzi M, Lo Presti A, Ciccaglione AR, Zehender G, Ciotti M. Phylogeny and phylodinamic of Hepatitis C in Italy. BMC Infect Dis 2012; 12 Suppl 2:S5. [PMID: 23173700 PMCID: PMC3495630 DOI: 10.1186/1471-2334-12-s2-s5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Hepatitis C virus infection (HCV) is one of the most pressing health emergencies in the world with a global prevalence of about 170 million people chronically infected worldwide. In Europe, Italy has the highest HCV prevalence (3 - 4.4%) with peaks of 12.6 - 26% in Southern regions and the major islands. In Italy HCV genotype 1b prevails, and genotype 4 is mainly found in the south of the country where the prevalence is particularly high in regions such as Calabria. Phylogenetics analysis is a molecular tool widely used to study rapidly-evolving RNA viruses that establish chronic infections such as HCV. Searching the scientific literature, it was found that thirty-nine genetic studies on HCV genotypes have been carried out in Italy between 1997 to 2012 years. However, phylogenetic analysis was performed only in fourteen out of thirty-nine HCV studies (36%) considered. Monitoring the genetic evolution of HCV is an essential step to control the local as well as global HCV epidemic and to develop efficient preventive and therapeutic strategies.
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Affiliation(s)
- Massimo Ciccozzi
- Department of Infectious, Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy.
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14
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Ciccozzi M, Lai A, Ebranati E, Gabanelli E, Galli M, Mugosa B, Vratnica Z, Vujoševic D, Lauševic D, Ciotti M, Cella E, Lo Presti A, Zehender G. Phylogeographic reconstruction of HIV type 1B in Montenegro and the Balkan region. AIDS Res Hum Retroviruses 2012; 28:1280-4. [PMID: 22364163 DOI: 10.1089/aid.2011.0138] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Human immunodeficiency virus (HIV) is one of the most genetically variable human viruses as it is characterized by high rates of mutation, viral replication, and recombination. Phylodynamics is a powerful means of describing the behavior of an infection as a combination of evolutionary and ecological processes. Only a few studies of HIV-1 molecular epidemiology have so far been carried out in the Balkans. In this study, we used Bayesian methods to reconstruct the phylogeography and phylodynamics of HIV-1B in Montenegro and some other Balkan countries on the basis of pol gene sequences retrieved from a public database. The phylogenetic analysis showed that 43% of the isolates grouped in accordance with their geographic area, whereas the majority were interspersed in the tree, thus confirming the multiple introductions of HIV-1B in the Balkans. The Bayesian phylogeographic analysis suggested that HIV-1B entered the Balkans in the early 1970s probably through Greece and other Mediterranean tourist/travel destinations (such as Slovenia). Other Balkan countries, such as Bulgaria and Serbia, may have played an important role in spreading the infection to the entire Eastern Mediterranean area, and possibly to Northeast Europe. This suggests that the Balkans may have played a role as a "gateway" between Western and Eastern Europe.
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Affiliation(s)
- Massimo Ciccozzi
- Epidemiology Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Italian Institute of Health, Rome, Italy
| | - Alessia Lai
- Department of Clinical Sciences, L. Sacco Hospital, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy
| | - Erika Ebranati
- Department of Clinical Sciences, L. Sacco Hospital, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy
| | - Elena Gabanelli
- Department of Clinical Sciences, L. Sacco Hospital, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy
| | - Massimo Galli
- Department of Clinical Sciences, L. Sacco Hospital, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy
| | - Boban Mugosa
- Institute of Public Health, Podgorica, Montenegro
| | | | | | | | - Marco Ciotti
- Laboratory of Molecular Virology, Foundation Polyclinic Tor Vergata, Rome, Italy
| | - Eleonora Cella
- Epidemiology Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Italian Institute of Health, Rome, Italy
| | - Alessandra Lo Presti
- Epidemiology Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Italian Institute of Health, Rome, Italy
| | - Gianguglielmo Zehender
- Department of Clinical Sciences, L. Sacco Hospital, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy
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