Molecular epidemiology of HIV-1 in Hungary: an evolving contact zone of colliding virus subtypes

作者：Levente Zsichla, Lilla Adravecz, Dalma Müller, Philippe Lemey, Áron Lakatos, Eszter Ari, Katharina Kusejko, Roger D. Kouyos, János Szlávik, Botond Lakatos, Éva Áy, Viktor Müller · 发表于：Frontiers in Microbiology · 年份：2025 · DOI：10.3389/fmicb.2025.1732254 · 被引用次数：1 · 研究领域：HIV Research and Treatment、HIV/AIDS Research and Interventions、HIV/AIDS drug development and treatment

Introduction: Although antiretroviral therapy can suppress the transmission of HIV-1, the pandemic persists and continues to evolve. Monitoring virus transmission patterns and evolving variants is therefore essential for improving prevention strategies. To address this need, we present the first comprehensive molecular epidemiological analysis of the HIV-1 epidemic in Hungary-a country in the contact zone of major HIV-1 subtypes A, B, and F. Methods: sequences obtained from 1,120 Hungarian patients in the context of routine drug resistance genotyping between 2008 and 2024, along with 2,202 international background sequences selected based on sequence similarity. We performed subtyping, drug resistance testing, maximum likelihood and Bayesian phylogenetic inference, distance-based and phylogenetic clustering, and Bayesian phylogeographic analyses to identify domestic clusters and cross-border transmission. Results: Most sequences (814/1,120) belonged to subtype B; however, the frequency of non-B subtypes (mainly A, F, and several recombinant forms) has increased steadily since 2014, reaching 41.3% in 2024. Phylogenetic analyses identified 136 domestic clusters and a large transmitted drug resistance clade persisting over two decades. Remarkably, one in six recent diagnoses mapped to a single cluster, and approximately a third of all new diagnoses to the five most active clusters. Individuals in larger clusters were more often young, men who have sex with men (MSM), and had hig...