High prevalence of non‐B HIV‐1 subtypes in seamen and their sexual partners in Croatia

Travel influences the spread of non‐B subtypes of HIV in Europe. The aim of this study was to assess whether the spread of non‐B subtypes occurred in Croatia, a country with a low level HIV infection. Phylogenetic analysis of the reverse transcriptase and protease genes was undertaken in 145 Croatian patients with the following risks for HIV‐infection: men who have sex with men (n = 64), heterosexual contact (n = 54), intravenous drug use (n = 21), bisexual contact (n = 4) and intravenous drug use plus heterosexual exposure (n = 2). The sample included 25 seamen and 13 steady female sexual partners of seamen. Overall, 38 (26%) of HIV‐patients were infected with non‐B subtypes. Non‐B subtype infections were found only in patients with a possible heterosexual exposure. Non‐B infections were most frequent in seamen and their regular female partners (in 27 of 38 seamen and their partners, 71%). The relative distribution of non‐B subtypes was as follows: A, 8%; C, 26%; F, 3%; CRF01_AE, 8%; CRF02_AG, 34%; CRF05_DF, 5%; CRF06_cpx, 3%; CRF10_CD 8%; and subtype U, 5%. There were altogether 19 heterosexual couples, phylogenetic analysis confirmed that the paired samples were related in all cases. Non‐B subtypes were found only in individuals with a heterosexual risk, mainly in seamen and their partners. J. Med. Virol. 81:573–577, 2009 © 2009 Wiley‐Liss, Inc.