{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T01:04:19Z","timestamp":1786755859393,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead","doi-asserted-by":"publisher","award":["1173"],"award-info":[{"award-number":["1173"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Despite the low prevalence of HIV-1 in Israel, continuous waves of immigration may have impacted the local epidemic. We characterized all people diagnosed with HIV-1 in Israel in 2010\u20132018. The demographics and clinical data of all individuals (n = 3639) newly diagnosed with HIV-1 were retrieved. Subtypes, transmitted drug-resistance mutations (TDRM), and phylogenetic relations, were determined in &gt;50% of them. In 39.1%, HIV-1 transmission was through heterosexual contact; 34.3% were men who have sex with men (MSM); and 10.4% were people who inject drugs. Many (&gt;65%) were immigrants. Israeli-born individuals were mostly (78.3%) MSM, whereas only 9% of those born in Sub-Saharan Africa (SSA), Eastern Europe and Central Asia (EEU\/CA), were MSM. The proportion of individuals from SSA decreased through the years 2010\u20132018 (21.1% in 2010\u20132012; 16.8% in 2016\u20132018) whereas those from EEU\/CA increased significantly (21% in 2010\u20132012; 27.8% in 2016\u20132018, p &lt; 0.001). TDRM were identified in 12.1%; 3.7, 3.3 and 6.6% had protease inhibitors (PI), nucleotide reverse transcriptase inhibitors (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI) TDRM, respectively, with the overall proportion remaining stable in the studied years. None had integrase TDRM. Subtype B was present in 43.9%, subtype A in 25.2% (A6 in 22.8 and A1 in 2.4%) and subtype C in 17.1% of individuals. Most MSM had subtype B. Subtype C carriers formed small clusters (with one unexpected MSM cluster), A1 formed a cluster mainly of locally-born patients with NNRTI mutations, and A6 formed a looser cluster of individuals mainly from EEU. Israelis, &lt;50 years old, carrying A1, had the highest risk for having TDRM. In conclusion, an increase in immigrants from EEU\/CA and a decrease in those from SSA characterized the HIV-1 epidemic in 2010\u20132018. Baseline resistance testing should still be recommended to identify TDRM, and improve surveillance and care.<\/jats:p>","DOI":"10.3390\/v14010071","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T23:35:09Z","timestamp":1641771309000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Epidemiology and Transmitted HIV-1 Drug Resistance among Treatment-Na\u00efve Individuals in Israel, 2010\u20132018"],"prefix":"10.3390","volume":"14","author":[{"given":"Tali","family":"Wagner","sequence":"first","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"},{"name":"Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neta S.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tami","family":"Halperin","sequence":"additional","affiliation":[{"name":"Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Chemtob","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Braun School of Public Health & Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem 9112102, Israel"},{"name":"Tuberculosis and AIDS Department, Ministry of Health, Jerusalem 9101002, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4716-1293","authenticated-orcid":false,"given":"Itzchak","family":"Levy","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"},{"name":"Chaim Sheba Medical Center, Infectious Disease Unit, Ramat Gan 5262112, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Elbirt","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Braun School of Public Health & Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem 9112102, Israel"},{"name":"Immunology, Kaplan Medical Center, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Shachar","sequence":"additional","affiliation":[{"name":"Immunology Unit, Rambam Health Care Campus, Haifa 3109601, Israel"},{"name":"Rappaport Faculty of Medicine, Institute of Technology, Technion, Haifa 3200003, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Olshtain-Pops","sequence":"additional","affiliation":[{"name":"Hadassah Medical Center, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hila","family":"Elinav","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Braun School of Public Health & Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem 9112102, Israel"},{"name":"Hadassah Medical Center, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Chowers","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"},{"name":"Infectious Diseases, Meir Medical Center, Kfar Saba 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valery","family":"Itsomin","sequence":"additional","affiliation":[{"name":"Hillel Yaffe Medical Center, Hadera 38100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaris","family":"Riesenberg","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"},{"name":"Soroka Medical Center, Infectious Disease Institute, Beer-Sheva 84101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Wax","sequence":"additional","affiliation":[{"name":"Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Shirazi","sequence":"additional","affiliation":[{"name":"Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Gozlan","sequence":"additional","affiliation":[{"name":"Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Matus","sequence":"additional","affiliation":[{"name":"Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Girshengorn","sequence":"additional","affiliation":[{"name":"Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rotem","family":"Marom","sequence":"additional","affiliation":[{"name":"Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Mendelson","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"},{"name":"Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Turner","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"},{"name":"Tel-Aviv Sourasky Medical Center, Crusaid Kobler AIDS Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3207-4226","authenticated-orcid":false,"given":"Orna","family":"Mor","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"},{"name":"Chaim Sheba Medical Center, National HIV-1 and Viral Hepatitis Reference Laboratory, Ramat Gan 5262112, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e003078","DOI":"10.1136\/bmjopen-2013-003078","article-title":"Thirty years of HIV in Israel: Current epidemiology and future challenges","volume":"3","author":"Mor","year":"2013","journal-title":"BMJ Open"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wagner, T., Olshtain-Pops, K., Wax, M., Horwitz, O., Shirazi, R., Gozlan, Y., Volnowitz, H., Mendelson, E., Levy, I., and Mor, O. (2020). HIV-1 infection among women in Israel, 2010\u20132018. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-05389-6"},{"key":"ref_3","unstructured":"Israel Seen (2020, December 31). Israel: A Melting Pot of Cultures. Available online: https:\/\/israelseen.com\/2012\/05\/29\/israel-a-melting-pot-of-cultures."},{"key":"ref_4","unstructured":"Jewish Virtual Library (2021, March 31). Total Immigration to Israel by Select Country by Year (1948\u2013Present). Available online: https:\/\/www.jewishvirtuallibrary.org\/total-immigration-to-israel-by-country-per-year."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/QAD.0000000000002057","article-title":"Sexual intermingling of Arab and Jewish MSM in Israel: Results of a molecular epidemiology study","volume":"33","author":"Zuckerman","year":"2019","journal-title":"AIDS"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1177\/095646240401501011","article-title":"Epidemiology of adult and adolescent HIV infection in Israel: A country of immigration","volume":"15","author":"Chemtob","year":"2004","journal-title":"Int. J. STD AIDS"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Grossman, Z., Avidor, B., Mor, Z., Chowers, M., Levy, I., Shahar, E., Riesenberg, K., Sthoeger, Z., Maayan, S., and Shao, W. (2015). A Population-Structured HIV Epidemic in Israel: Roles of Risk and Ethnicity. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0135061"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s12977-018-0461-y","article-title":"Characterization update of HIV-1 M subtypes diversity and proposal for subtypes A and D sub-subtypes reclassification","volume":"15","author":"Cerutti","year":"2018","journal-title":"Retrovirology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Mendes da Silva, R.K., Monteiro de Pina Araujo, I.I., Venegas Maciera, K., Gon\u00e7alves Morgado, M., and Lindenmeyer Guimar\u00e3es, M. (2021). Genetic Characterization of a New HIV-1 Sub-Subtype A in Cabo Verde, Denominated A8. Viruses, 13.","DOI":"10.3390\/v13061093"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Schl\u00f6sser, M., Kartashev, V.V., Mikkola, V.H., Shemshura, A., Saukhat, S., Kolpakov, D., Suladze, A., Tverdokhlebova, T., Hutt, K., and Heger, E. (2020). HIV-1 Sub-Subtype A6: Settings for Normalised Identification and Molecular Epidemiology in the Southern Federal District, Russia. Viruses, 12.","DOI":"10.3390\/v12040475"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1086\/426592","article-title":"Drug-Resistant HIV Infection among Drug-Naive Patients in Israel","volume":"40","author":"Grossman","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"ofz304","DOI":"10.1093\/ofid\/ofz304","article-title":"Transmission Dynamics of HIV Subtype A in Tel Aviv, Israel: Implications for HIV Spread and Eradication","volume":"6","author":"Grossman","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1097\/QAD.0000000000001611","article-title":"Pretreatment integrase strand transfer inhibitor resistance in North Carolina from 2010\u20132016","volume":"31","author":"Menza","year":"2017","journal-title":"AIDS"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bennett, D.E., Camacho, R.J., Otelea, D., Kuritzkes, D.R., Fleury, H., Kiuchi, M., Heneine, W., Kantor, R., Jordan, M.R., and Schapiro, J.M. (2009). Drug Resistance Mutations for Surveillance of Transmitted HIV-1 Drug-Resistance: 2009 Update. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0004724"},{"key":"ref_15","unstructured":"(2021, December 12). HIV Drug Resistance Database (HIVDB). Available online: https:\/\/hivdb.stanford.edu\/."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1080\/15284336.2019.1628460","article-title":"Dolutegravir plus rilpivirine as dual regimen in virologically suppressed HIV-1 infected patients in a clinical setting","volume":"20","author":"Casado","year":"2019","journal-title":"HIV Res. Clin. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"21846","DOI":"10.7448\/IAS.20.1.21846","article-title":"Comparison between next-generation and Sanger-based sequencing for the detection of transmitted drug-resistance mutations among recently infected HIV-1 patients in Israel, 2000\u20132014","volume":"20","author":"Moscona","year":"2017","journal-title":"J. Int. AIDS Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1128\/JCM.02652-12","article-title":"Evaluation of a Benchtop HIV Ultradeep Pyrosequencing Drug Resistance Assay in the Clinical Laboratory","volume":"51","author":"Avidor","year":"2013","journal-title":"J. Clin. Microbiol."},{"key":"ref_19","first-page":"1800390","article-title":"Piloting a surveillance system for HIV drug resistance in the European Union","volume":"24","author":"Bosman","year":"2019","journal-title":"Euro Surveill."},{"key":"ref_20","unstructured":"(2021, May 19). The Jewish Agency for Israel. Available online: https:\/\/archive.jewishagency.org\/he\/historical-aliyah\/content\/22095."},{"key":"ref_21","unstructured":"(2021, May 18). Ministry of Aliyah and Integration, Available online: https:\/\/www.gov.il\/en\/Departments\/General\/aliyah_slomo."},{"key":"ref_22","unstructured":"Emergency Care Data Set (ECDS) (2019). HIV\/AIDS Surveillance in Europe 2018 Data, Emergency Care Data Set (ECDS)."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.meegid.2016.06.033","article-title":"Molecular epidemiology of HIV-1 infection in Europe: An overview","volume":"46","author":"Beloukas","year":"2016","journal-title":"Infect. Genet. Evol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1177\/0956462419891023","article-title":"Continuum of HIV care of newly diagnosed individuals in Israel, 2011\u20132015: A population-based cohort study","volume":"31","author":"Chowers","year":"2020","journal-title":"Int. J. STD AIDS"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e012721","DOI":"10.1136\/bmjopen-2016-012721","article-title":"Data from: Missed opportunities for earlier diagnosis of HIV in patients that presented with advanced HIV disease: A retrospective cohort study","volume":"6","author":"Levy","year":"2016","journal-title":"BMJ Open"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Late Presenters Working Group in COHERE in EuroCoord, Mocroft, A., Lundgren, J., Antinori, A., Monforte Ad, B.J., and Bonnet, F. (2015). Late presentation for HIV care across Europe: Update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013. Euro Surveill., 20, 10\u20132807.","DOI":"10.2807\/1560-7917.ES.2015.20.47.30070"},{"key":"ref_27","unstructured":"World Health Organization (WHO) Team HIV\/AIDS (2021, December 09). HIV Drug Resistance Report 2019. Available online: https:\/\/www.who.int\/hiv\/pub\/drugresistance\/hivdr-report-2019\/en\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1080\/17425255.2019.1673367","article-title":"Current and emerging non-nucleoside reverse transcriptase inhibitors (NNRTIs) for HIV-1 treatment","volume":"15","author":"Wang","year":"2019","journal-title":"Expert Opin Drug Metab Toxicol."},{"key":"ref_29","first-page":"1211","article-title":"Risk of Drug Resistance Among Persons Acquiring HIV Within a Randomized Clinical Trial of Single- or Dual-Agent Preexposure Prophylaxis","volume":"211","author":"Lehman","year":"2015","journal-title":"J. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s12977-018-0420-7","article-title":"Efficacies of Cabotegravir and Bictegravir against drug-resistant HIV-1 integrase mutants","volume":"15","author":"Smith","year":"2018","journal-title":"Retrovirology"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/1\/71\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:56:36Z","timestamp":1760169396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/1\/71"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,31]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["v14010071"],"URL":"https:\/\/doi.org\/10.3390\/v14010071","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,31]]}}}