简短通讯:来自维多利亚湖乌干达渔业社区的近期感染且未接受过抗逆转录病毒治疗的个体中,1型人类免疫缺陷病毒的传播耐药性及传播簇证据
Short communication: HIV type 1 transmitted drug resistance and evidence of transmission clusters among recently infected antiretroviral-naive individuals from Ugandan fishing communities of Lake Victoria.
作者信息
Nazziwa Jamirah, Njai Harr Freeya, Ndembi Nicaise, Birungi Josephine, Lyagoba Fred, Gershim Asiki, Nakiyingi-Miiro Jessica, Nielsen Leslie, Mpendo Juliet, Nanvubya Annet, Debont Jan, Grosskurth Heiner, Kamali Anatoli, Seeley Janet, Kaleebu Pontiano
机构信息
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
出版信息
AIDS Res Hum Retroviruses. 2013 May;29(5):788-95. doi: 10.1089/aid.2012.0123.
Human immunodeficiency virus type 1 (HIV-1) prevalence and incidence in the fishing communities on Lake Victoria in Uganda are high. This population may play a role in driving the HIV epidemic in Uganda including the spread of transmitted drug resistance (TDR). We report data on TDR in this population among antiretroviral (ARV)-naive, recently infected individuals about 5 years after ARV scaling-up in Uganda. We identified phylogenetic transmission clusters and combined these with volunteer life histories in order to understand the sexual networks within this population. From a prospective cohort of 1,000 HIV-negative individuals recruited from five communities, 51 seroconverters were identified over a period of 2 years. From these, whole blood was collected and population sequencing of the HIV-1 pol gene (protease/reverse transcriptase) was performed from plasma. Drug resistance mutations (DRMs) were scored using the 2009 WHO list for surveillance of TDR. TDR prevalence categories were estimated using the WHO recommended truncated sampling technique for the surveillance of TDR for use in resource-limited settings (RLS). Of the samples 92% (47/51) were successfully genotyped. HIV-1 subtype frequencies were 15/47 (32%) A1, 20/47 (43%) D, 1/47 (2%) C, 1/47 (2%) G, and 10/47 (21%) unique recombinant forms. Nonnucleoside reverse transcriptase inhibitor (NNRTI) drug resistance mutation K103N was identified in two individuals and V106A in one (6%) suggesting that the level of TDR was moderate in this population. No nucleoside/tide reverse transcriptase inhibitor (NRTI) or protease inhibitor (PI) DRMs were detected. In this study, we identified five transmission clusters supported by high bootstrap values and low genetic distances. Of these, one pair included the two individuals with K103N. Two of the genotypic clusters corresponded with reported sexual partnerships as detected through prior in-depth interviews. The level of TDR to NNRTIs in these ARV-naive individuals was moderate by WHO threshold survey categorization. The transmission clusters suggest a high degree of sexual partner mixing between members of these communities.
乌干达维多利亚湖沿岸渔业社区的人类免疫缺陷病毒1型(HIV-1)流行率和发病率很高。这一人群可能在推动乌干达的HIV疫情,包括传播性耐药(TDR)的传播方面发挥作用。我们报告了乌干达扩大抗逆转录病毒药物(ARV)使用约5年后,这一人群中未接受过ARV治疗的近期感染者的TDR数据。我们确定了系统发育传播簇,并将其与志愿者的生活史相结合,以了解该人群中的性网络。在从五个社区招募的1000名HIV阴性个体的前瞻性队列中,在2年的时间里确定了51名血清转化者。从这些人中采集了全血,并从血浆中对HIV-1 pol基因(蛋白酶/逆转录酶)进行了群体测序。使用2009年世界卫生组织(WHO)监测TDR的列表对耐药突变(DRM)进行评分。TDR流行率类别采用WHO推荐的截断抽样技术进行估计,该技术用于资源有限环境(RLS)中TDR的监测。92%(47/51)的样本成功进行了基因分型。HIV-1亚型频率为15/47(32%)A1、20/47(43%)D、1/47(2%)C、1/47(2%)G和10/47(21%)独特重组形式。在两名个体中鉴定出非核苷类逆转录酶抑制剂(NNRTI)耐药突变K103N,一名个体中鉴定出V106A(6%),这表明该人群中TDR水平为中等。未检测到核苷/核苷酸类逆转录酶抑制剂(NRTI)或蛋白酶抑制剂(PI)DRM。在本研究中,我们确定了五个具有高自展值和低遗传距离支持的传播簇。其中,一对包括两名携带K103N的个体。通过先前深入访谈检测到,两个基因型簇与报告的性伴侣关系相对应。根据WHO阈值调查分类,这些未接受过ARV治疗个体中对NNRTIs的TDR水平为中等。传播簇表明这些社区成员之间存在高度的性伴侣混合。