HIV Monitoring Foundation, Academic Medical Centre, Amsterdam, The Netherlands.
AIDS. 2010 Jan 16;24(2):271-82. doi: 10.1097/QAD.0b013e328333ddee.
To obtain insight in the HIV-1 transmission networks among men having sex with men (MSM) in the Netherlands.
A phylogenetic tree was constructed from polymerase sequences isolated from 2877 HIV-1 subtype B-infected patients monitored as part of the AIDS Therapy Evaluation in the Netherlands (ATHENA) nationwide observational cohort.
For MSM with a known date of infection, the most similar sequences were selected as potential transmission pairs when they clustered with bootstrap value of at least 99%. Time from infection to onward transmission was estimated as the median time between dates of infection for each transmission pair. The source of infections with a resistant strain was traced using the entire phylogenetic tree.
Of sequences from 403 MSM with a known date of infection between 1987 and 2007, 175 (43%) formed 63 clusters. Median time to onward transmission was 1.4 years (interquartile range 0.6-2.7). Twenty-four (6%) MSM carried a virus with resistance-related mutations, 13 of these were in eight clusters together with sequences from 28 other patients in the entire phylogenetic tree. Six clusters contained sequences obtained from 29 men all presenting the same resistance-related mutations.
From our selection of likely transmission pairs, we conclude that onward transmission of HIV-1 from infected MSM in the Netherlands happens both during and after primary infection. Transmission of resistant strains from the antiretroviral therapy-treated population is limited, but strains with resistance-related mutations have formed subepidemics.
了解荷兰男男性行为者（MSM）中 HIV-1 的传播网络。
从 2877 名感染 HIV-1 亚型 B 的患者的聚合酶序列构建系统发育树，这些患者作为荷兰艾滋病治疗评估（ATHENA）全国观察队列的一部分进行监测。
对于已知感染日期的 MSM，当它们的聚类 bootstrap 值至少为 99%时，选择最相似的序列作为潜在的传播对。从感染到传播的时间估计为每个传播对感染日期的中位数时间。使用整个系统发育树追踪具有耐药株的感染源。
在 1987 年至 2007 年间 403 名已知感染日期的 MSM 的序列中，有 175 个（43%）形成了 63 个簇。传播的中位时间为 1.4 年（四分位间距 0.6-2.7）。24 名（6%）MSM 携带具有耐药相关突变的病毒，其中 13 名与整个系统发育树中其他 28 名患者的序列一起存在于 8 个簇中。6 个簇包含来自 29 名男子的序列，他们都呈现相同的耐药相关突变。
从我们选择的可能传播对来看，我们得出结论，荷兰受感染的 MSM 中 HIV-1 的传播既发生在原发性感染期间，也发生在原发性感染之后。从接受抗逆转录病毒治疗的人群中传播耐药株的情况有限，但具有耐药相关突变的菌株已形成亚流行。
