期刊
JOURNAL OF INFECTIOUS DISEASES
卷 201, 期 10, 页码 1488-1497出版社
OXFORD UNIV PRESS INC
DOI: 10.1086/651951
关键词
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资金
- Roche
- Abbott
- Bristol-Myers Squibb
- GlaxoSmithKline
- Tibotec
- Merck Sharp
- Dohme
- Swiss HIV Cohort Study (SHCS)
- Swiss National Science Foundation (SNF) [3345-062041, 3247B0-112594, 320000116035]
- SHCS [470, 528, 569]
- Union Bank of Switzerland
- European Community's Seventh Framework Programme [pp7/2007-2013, 223131]
- Novartis Foundation
Background. Sequence data from resistance testing offer unique opportunities to characterize the structure of human immunodeficiency virus (HIV) infection epidemics. Methods. We analyzed a representative set of HIV type 1 (HIV-1) subtype B pol sequences from 5700 patients enrolled in the Swiss HIV Cohort Study. We pooled these sequences with the same number of sequences from foreign epidemics, inferred a phylogeny, and identified Swiss transmission clusters as clades having a minimal size of 10 and containing >= 80% Swiss sequences. Results. More than one-half of Swiss patients were included within 60 transmission clusters. Most transmission clusters were significantly dominated by specific transmission routes, which were used to identify the following patient groups: men having sex with men (MSM) (38 transmission clusters; average cluster size, 29 patients) or patients acquiring HIV through heterosexual contact (HETs) and injection drug users (IDUs) (12 transmission clusters; average cluster size, 144 patients). Interestingly, there were no transmission clusters dominated by sequences from HETs only. Although 44% of all HETs who were infected between 1983 and 1986 clustered with injection drug users, this percentage decreased to 18% for 2003-2006 (P < .001), indicating a diminishing role of injection drug users in transmission among HETs over time. Conclusions. Our analysis suggests (1) the absence of a self-sustaining epidemic of HIV-1 subtype B in HETs in Switzerland and (2) a temporally decreasing clustering of HIV infections in HETs and IDUs.
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