期刊
JOURNAL OF INFECTIOUS DISEASES
卷 213, 期 9, 页码 1410-1418出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiv758
关键词
HIV; clusters; phylogenetics; subtypes; MSM; PWID; heterosexual; crossover; phylogeny; epidemiology
资金
- Pangea-HIV Consortium
- Bill & Melinda Gates Foundation
- Biotechnology and Biological Science Research Council
- National Institutes of Health [GM110749]
- United Kingdom Medical Research Council [164587]
- United Kingdom Department of Health
- Boehringer Ingelheim
- Bristol-Myers Squibb
- Gilead
- Tibotec (division of Janssen-Cilag)
- Roche
- Biotechnology and Biological Sciences Research Council [1098048, 1041234] Funding Source: researchfish
- Medical Research Council [MR/M004236/1, MC_UU_12023/15] Funding Source: researchfish
- MRC [MC_UU_12023/15, MR/M004236/1] Funding Source: UKRI
Background. The United Kingdom human immunodeficiency virus (HIV) epidemic was historically dominated by HIV subtype B transmission among men who have sex with men (MSM). Now 50% of diagnoses and prevalent infections are among heterosexual individuals and mainly involve non-B subtypes. Between 2002 and 2010, the prevalence of non- B diagnoses among MSM increased from 5.4% to 17%, and this study focused on the drivers of this change. Methods. Growth between 2007 and 2009 in transmission clusters among 14 000 subtype A1, C, D, and G sequences from the United Kingdom HIV Drug Resistance Database was analysed by risk group. Results. Of 1148 clusters containing at least 2 sequences in 2007, > 75% were pairs and > 90% were heterosexual. Most clusters (71.4%) did not grow during the study period. Growth was significantly lower for small clusters and higher for clusters of a parts per thousand yen7 sequences, with the highest growth observed for clusters comprising sequences from MSM and people who inject drugs (PWID). Risk group (P < .0001), cluster size (P < .0001), and subtype (P < .01) were predictive of growth in a generalized linear model. Discussion. Despite the increase in non-B subtypes associated with heterosexual transmission, MSM and PWID are at risk for non-B infections. Crossover of subtype C from heterosexuals to MSM has led to the expansion of this subtype within the United Kingdom.
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