@article{2999657,
    title = "Dating the Origin and Estimating the Transmission Rates of the Major HIV‐1 Clusters in Greece: Evidence about the Earliest Subtype A1 Epidemic in Europe",
    author = "Limnaios, S. and Kostaki, E.G. and Adamis, G. and Astriti, M. and Chini, M. and Mangafas, N. and Lazanas, M. and Patrinos, S. and Metallidis, S. and Tsachouridou, O. and Papastamopoulos, V. and Kakalou, E. and Chatzidimitriou, D. and Antoniadou, A. and Papadopoulos, A. and Psichogiou, M. and Basoulis, D. and Gova, M. and Pilalas, D. and Paraskeva, D. and Chrysos, G. and Paparizos, V. and Kourkounti, S. and Sambatakou, H. and Bolanos, V. and Sipsas, N.V. and Lada, M. and Barbounakis, E. and Kantzilaki, E. and Panagopoulos, P. and Maltezos, E. and Drimis, S. and Sypsa, V. and Lagiou, P. and Magiorkinis, G. and Hatzakis, A. and Skoura, L. and Paraskevis, D.",
    journal = "Virus Bulletin",
    year = "2022",
    volume = "14",
    number = "1",
    publisher = "MDPI",
    issn = "0956-9979",
    doi = "10.3390/v14010101",
    keywords = "adult;  antiretroviral therapy;  Article;  cluster analysis;  controlled study;  epidemic;  ethnicity;  Europe;  female;  gene sequence;  genetic distance;  Greece;  human;  Human immunodeficiency virus 1;  Human immunodeficiency virus infection;  major clinical study;  male;  Monte Carlo method;  nonhuman;  phylodynamics;  phylogeny;  prevalence;  sequence alignment;  transmission rate;  validation process;  virus transmission;  classification;  cluster analysis;  genetics;  Greece;  Human immunodeficiency virus 1;  Human immunodeficiency virus infection;  sexual and gender minority;  virology, Cluster Analysis;  Epidemics;  Europe;  Female;  Greece;  HIV Infections;  HIV-1;  Humans;  Male;  Sexual and Gender Minorities",
    abstract = "Our aim was to estimate the date of the origin and the transmission rates of the major local clusters of subtypes A1 and B in Greece. Phylodynamic analyses were conducted in 14 subtype A1 and 31 subtype B clusters. The earliest dates of origin for subtypes A1 and B were in 1982.6 and in 1985.5, respectively. The transmission rate for the subtype A1 clusters ranged between 7.54 and 39.61 infec-tions/100 person years (IQR: 9.39, 15.88), and for subtype B clusters between 4.42 and 36.44 infections/100 person years (IQR: 7.38, 15.04). Statistical analysis revealed that the average difference in the transmission rate between the PWID and the MSM clusters was 6.73 (95% CI: 0.86 to 12.60; p = 0.026). Our study provides evidence that the date of introduction of subtype A1 in Greece was the earliest in Europe. Transmission rates were significantly higher for PWID than MSM clusters due to the conditions that gave rise to an extensive PWID HIV‐1 outbreak ten years ago in Athens, Greece. Transmission rate can be consid-ered as a valuable measure for public health since it provides a proxy of the rate of epidemic growth within a cluster and, therefore, it can be useful for targeted HIV prevention programs. © 2022 by the authors. Licensee MDPI, Basel, Switzerland."
}