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1.
Nano Lett ; 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38819288

RESUMO

Analog neuromorphic computing systems emulate the parallelism and connectivity of the human brain, promising greater expressivity and energy efficiency compared to those of digital systems. Though many devices have emerged as candidates for artificial neurons and artificial synapses, there have been few device candidates for artificial dendrites. In this work, we report on biocompatible graphene-based artificial dendrites (GrADs) that can implement dendritic processing. By using a dual side-gate configuration, current applied through a Nafion membrane can be used to control device conductance across a trilayer graphene channel, showing spatiotemporal responses of leaky recurrent, alpha, and Gaussian dendritic potentials. The devices can be variably connected to enable higher-order neuronal responses, and we show through data-driven spiking neural network simulations that spiking activity is reduced by ≤15% without accuracy loss while low-frequency operation is stabilized. This positions the GrADs as strong candidates for energy efficient bio-interfaced spiking neural networks.

2.
Nano Lett ; 24(6): 1891-1900, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38150559

RESUMO

Two-dimensional (2D) transition metal dichalcogenide (TMD) layers are highly promising as field-effect transistor (FET) channels in the atomic-scale limit. However, accomplishing this superiority in scaled-up FETs remains challenging due to their van der Waals (vdW) bonding nature with respect to conventional metal electrodes. Herein, we report a scalable approach to fabricate centimeter-scale all-2D FET arrays of platinum diselenide (PtSe2) with in-plane platinum ditelluride (PtTe2) edge contacts, mitigating the aforementioned challenges. We realized a reversible transition between semiconducting PtSe2 and metallic PtTe2 via a low-temperature anion exchange reaction compatible with the back-end-of-line (BEOL) processes. All-2D PtSe2 FETs seamlessly edge-contacted with transited metallic PtTe2 exhibited significant performance improvements compared to those with surface-contacted gold electrodes, e.g., an increase of carrier mobility and on/off ratio by over an order of magnitude, achieving a maximum hole mobility of ∼50.30 cm2 V-1 s-1 at room temperature. This study opens up new opportunities toward atomically thin 2D-TMD-based circuitries with extraordinary functionalities.

3.
Int J Mol Sci ; 24(2)2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36674980

RESUMO

Viruses cause various infections that may affect human lifestyle for durations ranging from several days to for many years. Although preventative and therapeutic remedies are available for many viruses, they may still have a profound impact on human life. The human immunodeficiency virus type 1 is the most common cause of HIV infection, which represents one of the most dangerous and complex diseases since it affects the immune system and causes its disruption, leading to secondary complications and negatively influencing health-related quality of life. While highly active antiretroviral therapy may decrease the viral load and the velocity of HIV infection progression, some individual peculiarities may affect viral load control or the progression of T-cell malfunction induced by HIV. Our study is aimed at the text-based identification of molecular mechanisms that may be involved in viral infection progression, using HIV as a case study. Specifically, we identified human proteins and genes which commonly occurred, overexpressed or underexpressed, in the collections of publications relevant to (i) HIV infection progression and (ii) acute and chronic stages of HIV infection. Then, we considered biological processes that are controlled by the identified protein and genes. We verified the impact of the identified molecules in the associated clinical study.


Assuntos
Infecções por HIV , HIV-1 , Humanos , Qualidade de Vida , Terapia Antirretroviral de Alta Atividade , Mineração de Dados , Carga Viral
4.
Small ; 16(15): e1902820, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31592577

RESUMO

This review provides a critical overview of current developments on nanoelectronic biochemical sensors based on graphene. Composed of a single layer of conjugated carbon atoms, graphene has outstanding high carrier mobility and low intrinsic electrical noise, but a chemically inert surface. Surface functionalization is therefore crucial to unravel graphene sensitivity and selectivity for the detection of targeted analytes. To achieve optimal performance of graphene transistors for biochemical sensing, the tuning of the graphene surface properties via surface functionalization and passivation is highlighted, as well as the tuning of its electrical operation by utilizing multifrequency ambipolar configuration and a high frequency measurement scheme to overcome the Debye screening to achieve low noise and highly sensitive detection. Potential applications and prospectives of ultrasensitive graphene electronic biochemical sensors ranging from environmental monitoring and food safety, healthcare and medical diagnosis, to life science research, are presented as well.


Assuntos
Técnicas Biossensoriais , Eletrônica , Grafite , Carbono
6.
Sensors (Basel) ; 20(13)2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32630192

RESUMO

Iron deficiency (ID) is the most prevalent and severe nutritional disorder globally and is the leading cause of iron deficiency anemia (IDA). IDA often progresses subtly symptomatic in children, whereas prolonged deficiency may permanently impair development. Early detection and frequent screening are, therefore, essential to avoid the consequences of IDA. In order to reduce the production cost and complexities involved in building advanced ID sensors, the devices were fabricated using a home-built patterning procedure that was developed and used for this work instead of lithography, which allows for fast prototyping of dimensions. In this article, we report the development of graphene-based field-effect transistors (GFETs) functionalized with anti-ferritin antibodies through a linker molecule (1-pyrenebutanoic acid, succinimidyl ester), to facilitate specific conjugation with ferritin antigen. The resulting biosensors feature an unprecedented ferritin detection limit of 10 fM, indicating a tremendous potential for non-invasive (e.g., saliva) ferritin detection.


Assuntos
Anemia Ferropriva , Técnicas Biossensoriais , Grafite , Anemia Ferropriva/diagnóstico , Criança , Diagnóstico Precoce , Ferritinas/análise , Humanos
7.
Int J Mol Sci ; 21(3)2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31979356

RESUMO

Human Immunodeficiency Virus Type 1 (HIV-1) infection is associated with high mortality if no therapy is provided. Currently, the treatment of an HIV-1 positive patient requires that several drugs should be taken simultaneously. The resistance of the virus to an antiretroviral drug may lead to treatment failure. Our approach focuses on predicting the exposure of a particular viral variant to an antiretroviral drug or drug combination. It also aims at the prediction of drug treatment success or failure. We utilized nucleotide sequences of HIV-1 encoding protease and reverse transcriptase to perform such types of prediction. The PASS (Prediction of Activity Spectra for Substances) algorithm based on the naive Bayesian classifier was used to make a prediction. We calculated the probability of whether a sequence belonged (P1) or did not belong (P0) to the class associated with exposure of the viral sequence to the set of drugs that can be associated with resistance to the set of drugs. The accuracy calculated as the average Area Under the ROC (Receiver Operating Characteristic) Curve (AUC/ROC) for classifying exposure of the sequence to the HIV-1 protease inhibitors was 0.81 (±0.07), and for HIV-1 reverse transcriptase, it was 0.83 (±0.07). To predict cases of treatment effectiveness or failure, we used P1 and P0 values, obtained in PASS, along with the binary vector constructed based on short nucleotide descriptors and the applied random forest classifier. Average AUC/ROC prediction accuracy for the prediction of treatment effectiveness or failure for the combinations of HIV-1 protease inhibitors was 0.82 (±0.06) and of HIV-1 reverse transcriptase was 0.76 (±0.09).


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV-1/efeitos dos fármacos , Algoritmos , Fármacos Anti-HIV/farmacologia , Área Sob a Curva , Teorema de Bayes , Farmacorresistência Viral , Quimioterapia Combinada , Protease de HIV/química , Protease de HIV/genética , Inibidores da Protease de HIV/farmacologia , Transcriptase Reversa do HIV/química , Transcriptase Reversa do HIV/genética , HIV-1/genética , Humanos , Inibidores da Transcriptase Reversa/farmacologia , Falha de Tratamento , Resultado do Tratamento
8.
Nano Lett ; 16(4): 2295-300, 2016 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-26928906

RESUMO

In this Letter, the ambipolar properties of an electrolyte-gated graphene field-effect transistor (GFET) have been explored to fabricate frequency-doubling biochemical sensor devices. By biasing the ambipolar GFETs in a common-source configuration, an input sinusoidal voltage at frequency f applied to the electrolyte gate can be rectified to a sinusoidal wave at frequency 2f at the drain electrode. The extraordinary high carrier mobility of graphene and the strong electrolyte gate coupling provide the graphene ambipolar frequency doubler an unprecedented unity gain, as well as a detection limit of ∼4 pM for 11-mer single strand DNA molecules in 1 mM PBS buffer solution. Combined with an improved drift characteristics and an enhanced low-frequency 1/f noise performance by sampling at doubled frequency, this good detection limit suggests the graphene ambipolar frequency doubler a highly promising biochemical sensing platform.


Assuntos
Técnicas Biossensoriais/métodos , DNA de Cadeia Simples/análise , Grafite/química , Técnicas Biossensoriais/instrumentação
9.
Physiol Meas ; 45(5)2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38599226

RESUMO

Objective.Making up one of the largest shares of diagnosed cancers worldwide, skin cancer is also one of the most treatable. However, this is contingent upon early diagnosis and correct skin cancer-type differentiation. Currently, methods for early detection that are accurate, rapid, and non-invasive are limited. However, literature demonstrating the impedance differences between benign and malignant skin cancers, as well as between different types of skin cancer, show that methods based on impedance differentiation may be promising.Approach.In this work, we propose a novel approach to rapid and non-invasive skin cancer diagnosis that leverages the technologies of difference-based electrical impedance tomography (EIT) and graphene electronic tattoos (GETs).Main results.We demonstrate the feasibility of this first-of-its-kind system using both computational numerical and experimental skin phantom models. We considered variations in skin cancer lesion impedance, size, shape, and position relative to the electrodes and evaluated the impact of using individual and multi-electrode GET (mGET) arrays. The results demonstrate that this approach has the potential to differentiate based on lesion impedance, size, and position, but additional techniques are needed to determine shape.Significance.In this way, the system proposed in this work, which combines both EIT and GET technology, exhibits potential as an entirely non-invasive and rapid approach to skin cancer diagnosis.


Assuntos
Impedância Elétrica , Grafite , Imagens de Fantasmas , Neoplasias Cutâneas , Tomografia , Grafite/química , Tomografia/instrumentação , Tomografia/métodos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/diagnóstico por imagem , Humanos , Eletrodos , Tatuagem
10.
Curr HIV Res ; 21(6): 347-353, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38058095

RESUMO

OBJECTIVE: The study aimed to compare the prevalence of surveillance HIV drug resistance mutations (SDRMs) across the main federal districts of Russia. METHODS: A pooled analysis was conducted to examine data on HIV primary drug resistance (HIV PrimDR). The analysis was based on published results primarily from Russian regional clinical and scientific laboratories, covering a span of 20 years. RESULTS: The findings indicate that three surveyed regions, namely Central, Far Eastern, and Volga, exhibit a low level of HIV PrimDR prevalence (not exceeding 5%), and this prevalence does not show a tendency to increase. In contrast, three major regions, namely Northwestern, Southern, and Siberian, demonstrate a significant and progressive increase in HIV PrimDR prevalence, with recent values surpassing 10%. CONCLUSION: Consequently, it was concluded that a change in the HIV treatment strategy in these regions is imperative, emphasizing the need to expedite the transition to the utilization of secondgeneration integrase inhibitors.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Humanos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Mutação , Federação Russa/epidemiologia , Prevalência , Farmacorresistência Viral/genética , Genótipo
11.
Front Bioeng Biotechnol ; 11: 1168667, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37256116

RESUMO

Graphene, a 2D carbon allotrope, is revolutionizing many biomedical applications due to its unique mechanical, electrical, thermal, and optical properties. When bioengineers realized that these properties could dramatically enhance the performance of cardiac sensors and actuators and may offer fundamentally novel technological capabilities, the field exploded with numerous studies developing new graphene-based systems and testing their limits. Here we will review the link between specific properties of graphene and mechanisms of action of cardiac sensors and actuators, analyze the performance of these systems from inaugural studies to the present, and offer future perspectives.

12.
Pathogens ; 12(7)2023 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-37513727

RESUMO

More than 50% of all people living with HIV worldwide are women. Globally, HIV/AIDS is the leading cause of death among women aged 15 to 44. The safe and effective methods of hormonal contraception are an essential component of preventive medical care in order to reduce maternal and infant mortality. However, there is limited knowledge regarding the effect of hormones on the rate of viral replication in HIV infection, especially non-B subtypes. The goal of the present work was to study in vitro how the female hormones ß-estradiol and progesterone affect the replication of the HIV-1 subtypes A6, CRF02_AG, and B. The findings show that high doses of hormones enhanced the replication of HIV-1 sub-subtype A6 by an average of 1.75 times and the recombinant variant CRF02_AG by 1.4 times but did not affect the replication of HIV-1 subtype B. No difference was detected in the expression of CCR5 and CXCR4 co-receptors on the cell surface, either in the presence or absence of hormones. However, one of the reasons for the increased viral replication could be the modulated TLRs secretion, as it was found that high doses of estradiol and progesterone upregulated, to varying degrees, the expression of TLR2 and TLR9 genes in the PBMCs of female donors infected with HIV-1 sub-subtype A6.

13.
ACS Nano ; 17(18): 18629-18640, 2023 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-37703454

RESUMO

The SARS-CoV-2 pandemic has highlighted the need for devices capable of carrying out rapid differential detection of viruses that may manifest similar physiological symptoms yet demand tailored treatment plans. Seasonal influenza may be exacerbated by COVID-19 infections, increasing the burden on healthcare systems. In this work, we demonstrate a technology based on liquid-gated graphene field-effect transistors (GFETs), for rapid and ultraprecise sensing and differentiation of influenza and SARS-CoV-2 surface protein. Most distinctively, the device consists of 4 onboard GFETs arranged in a quadruple architecture, where each quarter is functionalized individually (with either antibodies or chemically passivated control) but measured jointly. The sensor platform was tested against a range of concentrations of viral surface proteins from both viruses with the lowest tested and detected concentration at ∼50 ag/mL, or 88 zM for COVID-19 and 227 zM for Flu, which is 5-fold lower than the values reported previously on a similar platform. Unlike the classic real-time polymerase chain reaction test, which has a turnaround time of a few hours, the graphene technology presents an ultrafast response time of ∼10 s even in complex and clinically relevant media such as saliva. Thus, we have developed a multianalyte, highly sensitive, and fault-tolerant technology for rapid diagnostic of contemporary, emerging, and future pandemics.


Assuntos
COVID-19 , Grafite , Influenza Humana , Humanos , SARS-CoV-2 , COVID-19/diagnóstico , Anticorpos
14.
Biosens Bioelectron ; 222: 114993, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36525710

RESUMO

The organized self-assembly of conductive biological structures holds promise for creating new bioelectronic devices. In particular, Geobacter sulfurreducens type IVa pili have proven to be a versatile material for fabricating protein nanowire-based devices. To scale the production of conductive pili, we designed a strain of Shewanella oneidensis that heterologously expressed abundant, conductive Geobacter pili when grown aerobically in liquid culture. S. oneidensis expressing a cysteine-modified pilin, designed to enhance the capability to bind to gold, generated conductive pili that self-assembled into biohybrid filaments in the presence of gold nanoparticles. Elemental composition analysis confirmed the filament-metal interactions within the structures, which were several orders of magnitude larger than previously described metal:organic filaments. The results demonstrate that the S. oneidensis chassis significantly advances the possibilities for facile conductive protein nanowire design and fabrication.


Assuntos
Técnicas Biossensoriais , Geobacter , Nanopartículas Metálicas , Ouro , Fímbrias Bacterianas/metabolismo , Transporte de Elétrons
15.
Adv Mater ; 35(22): e2212190, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36965107

RESUMO

Heart rhythm disorders, known as arrhythmias, cause significant morbidity and are one of the leading causes of mortality. Cardiac arrhythmias are frequently treated by implantable devices, such as pacemakers and defibrillators, or by ablation therapy guided by electroanatomical mapping. Both implantable and ablation therapies require sophisticated biointerfaces for electrophysiological measurements of electrograms and delivery of therapeutic stimulation or ablation energy. In this work, a graphene biointerface for in vivo cardiac electrophysiology is reported for the first time. Leveraging sub-micrometer-thick tissue-conformable graphene arrays, sensing and stimulation of the open mammalian heart are demonstrated both in vitro and in vivo. Furthermore, the graphene biointerface treatment of atrioventricular block (the kind of arrhythmia where the electrical conduction from the atria to the ventricles is interrupted) is demonstrated. The graphene arrays show effective electrochemical properties, namely interface impedance down to 40 Ω cm2 at 1 kHz, charge storage capacity up to 63.7 mC cm-2 , and charge injection capacity up to 704 µC cm-2 . Transparency of the graphene structures allows for simultaneous optical mapping of cardiac action potentials, calcium transients, and optogenetic stimulation while performing electrical measurements and stimulation. The report presents evidence of the significant potential of graphene biointerfaces for advanced cardiac electrophysiology and arrhythmia therapy.


Assuntos
Grafite , Animais , Humanos , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/terapia , Coração , Ventrículos do Coração , Mamíferos
16.
Viruses ; 15(4)2023 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-37112971

RESUMO

In Russia, antiretroviral therapy (ART) coverage has significantly increased, which, in the absence of routine genotyping testing, could lead to an increase in HIV drug resistance (DR). The aim of this study was to investigate the patterns and temporal trends in HIV DR as well as the prevalence of genetic variants in treatment-naïve patients from 2006 to 2022, using data from the Russian database (4481 protease and reverse transcriptase and 844 integrase gene sequences). HIV genetic variants, and DR and DR mutations (DRMs) were determined using the Stanford Database. The analysis showed high viral diversity, with the predominance of A6 (78.4%), which was the most common in all transmission risk groups. The overall prevalence of surveillance DRMs (SDRMs) was 5.4%, and it reached 10.0% in 2022. Most patients harbored NNRTI SDRMs (3.3%). The prevalence of SDRMs was highest in the Ural (7.9%). Male gender and the CRF63_02A6 variant were association factors with SDRMs. The overall prevalence of DR was 12.7% and increased over time, primarily due to NNRTIs. Because baseline HIV genotyping is unavailable in Russia, it is necessary to conduct surveillance of HIV DR due to the increased ART coverage and DR prevalence. Centralized collection and unified analysis of all received genotypes in the national database can help in understanding the patterns and trends in DR to improve treatment protocols and increase the effectiveness of ART. Moreover, using the national database can help identify regions or transmission risk groups with a high prevalence of HIV DR for epidemiological measures to prevent the spread of HIV DR in the country.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Soropositividade para HIV , HIV-1 , Humanos , Masculino , HIV-1/genética , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Farmacorresistência Viral/genética , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Mutação , Genótipo , Prevalência , Federação Russa/epidemiologia
17.
ACS Nano ; 17(6): 5211-5295, 2023 03 28.
Artigo em Inglês | MEDLINE | ID: mdl-36892156

RESUMO

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.


Assuntos
Dispositivos Eletrônicos Vestíveis , Humanos , Qualidade de Vida
18.
Nat Nanotechnol ; 17(8): 864-870, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35725927

RESUMO

Continuous monitoring of arterial blood pressure (BP) in non-clinical (ambulatory) settings is essential for understanding numerous health conditions, including cardiovascular diseases. Besides their importance in medical diagnosis, ambulatory BP monitoring platforms can advance disease correlation with individual behaviour, daily habits and lifestyle, potentially enabling analysis of root causes, prognosis and disease prevention. Although conventional ambulatory BP devices exist, they are uncomfortable, bulky and intrusive. Here we introduce a wearable continuous BP monitoring platform that is based on electrical bioimpedance and leverages atomically thin, self-adhesive, lightweight and unobtrusive graphene electronic tattoos as human bioelectronic interfaces. The graphene electronic tattoos are used to monitor arterial BP for >300 min, a period tenfold longer than reported in previous studies. The BP is recorded continuously and non-invasively, with an accuracy of 0.2 ± 4.5 mm Hg for diastolic pressures and 0.2 ± 5.8 mm Hg for systolic pressures, a performance equivalent to Grade A classification.


Assuntos
Grafite , Tatuagem , Pressão Arterial , Determinação da Pressão Arterial , Monitorização Ambulatorial da Pressão Arterial , Humanos
19.
Adv Mater ; 34(3): e2106615, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34751484

RESUMO

A major challenge for graphene applications is the lack of mass production technology for large-scale and high-quality graphene growth and transfer. Here, a roll-to-roll (R2R) dry transfer process for large-scale graphene grown by chemical vapor deposition is reported. The process is fast, controllable, and environmentally benign. It avoids chemical contamination and allows the reuse of graphene growth substrates. By controlling tension and speed of the R2R dry transfer process, the electrical sheet resistance is achieved as 9.5 kΩ sq-1 , the lowest ever reported among R2R dry transferred graphene samples. The R2R dry transferred samples are used to fabricate graphene-based field-effect transistors (GFETs) on polymer. It is demonstrated that these flexible GFETs feature a near-zero doping level and a gate leakage current one to two orders of magnitude lower than those fabricated using wet-chemical etched graphene samples. The scalability and uniformity of the R2R dry transferred graphene is further demonstrated by successfully transferring a 3 × 3 in2 sample and measuring its field-effect mobility with 36 millimeter-scaled GFETs evenly spaced on the sample. The field-effect mobility of the R2R dry transferred graphene is determined to be 205 ± 36 cm2  V-1 .

20.
Virus Evol ; 8(1): veac044, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35775027

RESUMO

The HIV/AIDS epidemic in Russia is growing, with approximately 100,000 people infected annually. Molecular epidemiology can provide insight into the structure and dynamics of the epidemic. However, its applicability in Russia is limited by the weakness of genetic surveillance, as viral genetic data are only available for <1 per cent of cases. Here, we provide a detailed description of the HIV-1 epidemic for one geographic region of Russia, Oryol Oblast, by collecting and sequencing viral samples from about a third of its known HIV-positive population (768 out of 2,157 patients). We identify multiple introductions of HIV-1 into Oryol Oblast, resulting in eighty-two transmission lineages that together comprise 66 per cent of the samples. Most introductions are of subtype A (315/332), the predominant HIV-1 subtype in Russia, followed by CRF63 and subtype B. Bayesian analysis estimates the effective reproduction number Re for subtype A at 2.8 [1.7-4.4], in line with a growing epidemic. The frequency of CRF63 has been growing more rapidly, with the median Re of 11.8 [4.6-28.7], in agreement with recent reports of this variant rising in frequency in some regions of Russia. In contrast to the patterns described previously in European and North American countries, we see no overrepresentation of males in transmission lineages; meanwhile, injecting drug users are overrepresented in transmission lineages. This likely reflects the structure of the HIV-1 epidemic in Russia dominated by heterosexual and, to a smaller extent, people who inject drugs transmission. Samples attributed to men who have sex with men (MSM) transmission are associated with subtype B and are less prevalent than expected from the male-to-female ratio for this subtype, suggesting underreporting of the MSM transmission route. Together, our results provide a high-resolution description of the HIV-1 epidemic in Oryol Oblast, Russia, characterized by frequent interregional transmission, rapid growth of the epidemic, and rapid displacement of subtype A with the recombinant CRF63 variant.

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