@article{3002885,
    title = "Limited cross-border infections in patients newly diagnosed with HIV in Europe",
    author = "Frentz, D. and Wensing, A.M.J. and Albert, J. and Paraskevis, D. and Abecasis, A.B. and Hamouda, O. and Jørgensen, L.B. and Kücherer, C. and Struck, D. and Schmit, J.-C. and Åsjö, B. and Balotta, C. and Beshkov, D. and Camacho, R.J. and Clotet, B. and Coughlan, S. and De Wit, S. and Griskevicius, A. and Grossman, Z. and Horban, A. and Kolupajeva, T. and Korn, K. and Kostrikis, L.G. and Liitsola, K. and Linka, M. and Nielsen, C. and Otelea, D. and Paredes, R. and Poljak, M. and Puchhammer-Stöckl, E. and Sönnerborg, A. and Stanekova, D. and Stanojevic, M. and Vandamme, A.-M. and Boucher, C.A.B. and Van de Vijver, D.A.M.C. and Balluch, G. and Vercauteren, J. and Derdelinckx, I. and Sasse, A. and Bogaert, M. and Ceunen, H. and De Roo, A. and Roo, D. and Echahidi, F. and Fransen, K. and Goffard, J.-C. and Goubau, P. and Goudeseune, E. and Yombi, J.-C. and Lacor, P. and Liesnard, C. and Moutschen, M. and Pierard, D. and Rens, R. and Schrooten, Y. and Vaira, D. and Vandekerckhove, L.P.R. and Van den Heuvel, A. and Van Der Gucht, B. and Van Ranst, M. and Van Wijngaerden, E. and Vandercam, B. and Vekemans, M. and Verhofstede, C. and Clumeck, N. and Van Laethem, K. and Demetriades, I. and Kousiappa, I. and Demetriou, V. and Hezka, J. and Bruckova, M. and Linka, M. and Machala, L. and Nielsen, C. and Jørgensen, L.B. and Gerstoft, J. and Mathiesen, L. and Pedersen, C. and Nielsen, H. and Laursen, A. and Kvinesdal, B. and Salminen, M. and Ristola, M. and Liitsola, K. and Suni, J. and Sutinen, J. and Korn, K. and Kücherer, C. and Berg, T. and Braun, P. and Poggensee, G. and Däumer, M. and Eberle, J. and Heiken, H. and Kaiser, R. and Knechten, H. and Müller, H. and Neifer, S. and Schmidt, B. and Walter, H. and Gunsenheimer-Bartmeyer, B. and Harrer, T. and Paraskevis, D. and Hatzakis, A. and Magiorkinis, E. and Hatzitheodorou, E. and Haida, C. and Zavitsanou, A. and Magiorkinis, G. and Lazanas, M. and Chini, M. and Magafas, N. and Tsogas, N. and Paparizos, V. and Kourkounti, S. and Antoniadou, A. and Papadopoulos, A. and Panagopoulos, P. and Poulakou, G. and Sakka, V. and Chryssos, G. and Drimis, S. and Gargalianos, P. and Lelekis, M. and Chilomenos, G. and Psichogiou, M. and Daikos, G.L. and Panos, G. and Haratsis, G. and Kordossis, T. and Kontos, A. and Koratzanis, G. and Theodoridou, M. and Mostrou, G. and Spoulou, V. and Coughlan, S. and De Gascun, C. and Byrne, C. and Duffy, M. and Bergin, C. and Reidy, D. and Farrell, G. and Lambert, J. and O'Connor, E. and Rochford, A. and Low, J. and Coakely, P. and O'Dea, S. and Hall, W. and Grossman, Z. and Levi, I. and Chemtob, D. and Balotta, C. and Franzetti, M. and Lai, A. and Binda, F. and Tramuto, F. and Ciccozzi, M. and Mussini, C. and Angarano, G. and Rezza, G. and Schmit, J.C. and Struck, D. and Hemmer, R. and Arendt, V. and Staub, T. and Schneider, F. and Roman, F. and Wensing, A.M.J. and Boucher, C.A.B. and van Kessel, A. and van Bentum, P.H.M. and Brinkman, K. and de Coul, E.L. and van der Ende, M.E. and Hoepelman, I.M. and van Kasteren, M. and Juttmann, J. and Kuipers, M. and Langebeek, N. and Richter, C. and Santegoets, R.M.W.J. and Schrijnders-Gudde, L. and Schuurman, R. and van de Ven, B.J.M. and Åsjö, B. and Ormaasen, V. and Aavitsland, P. and Horban, A. and Stanczak, J.J. and Stanczak, G.P. and Firlag-Burkacka, E. and Wiercinska-Drapalo, A. and Jablonowska, E. and Malolepsza, E. and Leszczyszyn-Pynka, M. and Szata, W. and Camacho, R. and Palma, C. and Borges, F. and Paixão, T. and Duque, V. and Araújo, F. and Jevtovic, D. and Salemovic, D. and Stanekova, D. and Habekova, M. and Mokras, M. and Truska, P. and Poljak, M. and Lunar, M. and Babic, D. and Tomazic, J. and Vidmar, L. and Vovko, T. and Karner, P. and Clotet, B. and Domingo, P. and Galindo, M.J. and Miralles, C. and del Pozo, M.A. and Ribera, E. and Iribarren, J.A. and Ruiz, L. and de la Torre, J. and Vidal, F. and Garcia, F. and Paredes, R. and Albert, J. and Heidarian, A. and Aperia-Peipke, K. and Axelsson, M. and Mild, M. and Karlsson, A. and Sönnerborg, A. and Thalme, A. and Navér, L. and Bratt, G. and Karlsson, A. and Blaxhult, A. and Gisslén, M. and Svennerholm, B. and Bergbrant, I. and Björkman, P. and Säll, C. and Mellgren, Å. and Lindholm, A. and Kuylenstierna, N. and Montelius, R. and Azimi, F. and Johansson, B. and Carlsson, M. and Johansson, E. and Ljungberg, B. and Ekvall, H. and Strand, A. and Mäkitalo, S. and öberg, S. and Holmblad, P. and Höfer, M. and Holmberg, H. and Josefson, P. and Ryding, U. and SPREAD Programme",
    journal = "Retrovirology",
    year = "2013",
    volume = "10",
    number = "1",
    publisher = "BioMed Central Ltd.",
    issn = "1742-4690",
    doi = "10.1186/1742-4690-10-36",
    keywords = "article;  cluster analysis;  Europe;  female;  geographic distribution;  high risk population;  human;  Human immunodeficiency virus 1;  Human immunodeficiency virus 1 infection;  Israel;  major clinical study;  male;  male homosexual;  nonhuman;  nucleotide sequence;  phylogeny;  structural gene;  travel;  unindexed sequence;  virus transmission, Human immunodeficiency virus 1",
    abstract = "Background: International travel plays a role in the spread of HIV-1 across Europe. It is, however, not known whether international travel is more important for spread of the epidemic as compared to endogenous infections within single countries. In this study, phylogenetic associations among HIV of newly diagnosed patients were determined across Europe.Results: Data came from the SPREAD programme which collects samples of newly diagnosed patients that are representative for national HIV epidemics. 4260 pol sequences from 25 European countries and Israel collected in 2002-2007 were included.We identified 457 clusters including 1330 persons (31.2% of all patients). The cluster size ranged between 2 and 28. A number of 987 patients (74.2%) were part of a cluster that consisted only of patients originating from the same country. In addition, 135 patients (10.2%) were in a cluster including only individuals from neighboring countries. Finally, 208 patients (15.6%) clustered with individuals from countries without a common border. Clustering with patients from the same country was less prevalent in patients being infected with B subtype (P-value <0.0001), in men who have sex with men (P-value <0.0001), and in recently infected patients (P-value =0.045).Conclusions: Our findings indicate that the transmission of HIV-1 in Europe is predominantly occurring between patients from the same country. This could have implications for HIV-1 transmission prevention programmes. Because infections through travelling between countries is not frequently observed it is important to have good surveillance of the national HIV-1 epidemics. © 2013 Frentz et al.; licensee BioMed Central Ltd."
}