| Summary: | The HIV epidemic in Constanta describes a unique pattern in the world. It has outbreak in 1986, in the pediatric population and it is of a monoclonal aspect, being determined by the F1 subtype. The evolution of the epidemic has known different stages in time: it spreads to the adult population, the transmission pathway becomes predominantly sexual and the circulating viral strains become diversified. The study proposes the characterization of the circulating HIV-1 subtypes in Constanta from the beginning of the epidemic to the present. The results indicate that subtype F1 remains dominant in patients from Constanta, mainly due to cases coming from the pediatric cohort that have now reached adulthood and are generating secondary cases through sexual transmission. As subtype B strains appeared sporadically before 1999, the strains C and B appear systematically after that moment in time. In 2004 the first subtype A strains were isolated. The year 2007 is the one with the highest biodiversity: along with the dominant subtype F1, subtypes C, A, B, G were isolated and also the circulating recombinant forms CRF02_02, CRF06_cpx and CRF01_AE. Since 2008, the viral population has remained polymorphic, with a dynamic evolution.
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