D. Paraskevis1*, S, Paraschiv2, V. Sypsa1, G. Nikolopoulos3, C. Tsiara3, G. Magiorkinis4, M. Psichogiou5, I. Niculescu2, I. Batan2, M. Malliori5, D. Otelea2, A.

Pharris7, A. Hatzakis1

1National Retrovirus Reference Center, Medical School, University of Athens, Athens, Greece,

2Molecular Diagnostics Laboratory, National Institute for Infectious Diseases, Bucharest, Romania, 3Hellenic Center for Diseases Control and Prevention, Athens, Greece, 4Department of Zoology,

University of Oxford, UK, 5Medical School, University of Athens, Athens, Greece, 6European Centre for Disease Prevention and Control, Stockholm, Sweden

*contact: dparask@med.uoa.gr

A comparison of HIV-1 molecular epidemiology among IDUs in Athens and Bucharest: The role of molecular surveillance in

Public Health

(Poster number TUPDB0105)

Introduction• In Athens Metropolitan area, during the first months of 2011

an unprecedented upward shift in the number of newly HIV-1 diagnosed IDUs was observed

• Similarly in Romania, the incidence of HIV-1 among IDUs was increased in the recent years

• We aimed to identify and compare the characteristics (frequency of HIV-1 clades, transmission patterns and dynamics, origin of infection) of both epidemics by means of molecular epidemiology studies

• Phylodynamic and phylogeographic analyses were performed on 122 and 557 outbreak sequences collected during 2011- 2013 in Romania and Greece. Additionally we included 3,448 sequences as references

• Analyses were performed using the current state of the art methods (Bayesian, maximum likelihood methods)

Major findingsCommon features• Recent HIV-1 outbreaks among IDUs in Romania and

Greece are spreading through three (CRF14_BG and two Fs) and four transmission clusters (CRF14_BG, CRF35_AD, A, B), respectively

• The majority of infections (>90%) occur within the IDU clusters. Common recombinant viruses (CRF14_BG) are circulating in both regions

• The CRF14_BG cluster in Greece originated from Romania• The exponential phase of epidemic growth was estimated

around the 8th of 2009 and 6th of 2010 for Bucharest and Athens, respectively

Phylodynamic analysis of IDU suboutbreaks from Greece and Romania

RomaniaGreece

Major findingsDifferences• All HIV-1 infections (subtype F and CRF14_BG) in

Romania originated from locally circulating strains• The locally circulating strains in Greece (sub-outbreaks A

and B) represent < 20% of infections

Conclusion• Molecular epidemiology was used to determine the

features of the recent outbreaks in Greece and Romania. Our study provides an example about the advances of molecular methods for outbreak investigation and thus for Public Health. Especially in Greece design of interventions for the outbreak were based on findings from our molecular epidemiology studies

Acknowledgments• Implemented under NSRF 2007-2013 and co-funded by European

Social Fund and national resources (MIS 365008). Additional support: NGO Praxis, NGO Positive Voice, Hellenic Scientific Society for the study of AIDS and STDs,

• The authors would like to acknowledge the contribution of the following persons: Aristotle staff: C. Bagos, M. Esmaili, M. Hasan, E. Karamanou, F. Leobilla, C. Mourtezou, E. Sidrou, M. Zigouritsas, M. Dimitropoulou, N. Kaguelari, M. Michail, S. Papadopoulos, A. Vlahos. Athens University Medical School: V. Benetou, A. Gkegka, E. Hatzitheodorou, P. Iliopoulos, M. Katsimicha, G. Kokolesi, V. Milona, H. Papachristou, C. Rocca, M. Souvatzi, S. Tripou, A. Vassilakis, M. Zavitsanou. Organization Against Drugs: K. Gazgalidis. Greek Reitox Focal Point of the European Monitoring Centre for Drugs and Drug Addiction: A. Fotiou. The volunteers of NGO "Positive Voice" and NGO "Praksis“