在英国，非B型艾滋病毒亚型的传播越来越受到大型非异性传播集群的推动。

Transmission of Non-B HIV Subtypes in the United Kingdom Is Increasingly Driven by Large Non-Heterosexual Transmission Clusters.

作者信息

Ragonnet-Cronin Manon, Lycett Samantha J, Hodcroft Emma B, Hué Stéphane, Fearnhill Esther, Brown Alison E, Delpech Valerie, Dunn David, Leigh Brown Andrew J

机构信息

Institute for Evolutionary Biology.

Roslin Institute, University of Edinburgh, Edinburgh.

出版信息

J Infect Dis. 2016 May 1;213(9):1410-8. doi: 10.1093/infdis/jiv758. Epub 2015 Dec 23.

DOI:10.1093/infdis/jiv758

PMID:26704616

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4813743/

Abstract

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 ≥7 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.

摘要

背景

在英国，人类免疫缺陷病毒（HIV）流行情况在历史上以男男性行为者（MSM）中B型HIV亚型传播为主。如今，50%的HIV诊断病例和现患感染病例出现在异性恋个体中，且主要涉及非B亚型。在2002年至2010年期间，MSM中非B型诊断病例的患病率从5.4%增至17%，本研究聚焦于这一变化的驱动因素。

方法

通过风险组分析了2007年至2009年期间来自英国HIV耐药数据库的14000个A1、C、D和G亚型序列的传播簇的增长情况。

结果

2007年，在1148个包含至少2个序列的簇中，超过75%为成对序列，超过90%为异性恋传播。在研究期间，大多数簇（71.4%）没有增长。小簇的增长显著较低，≥7个序列的簇增长较高，其中由MSM和注射吸毒者（PWID）的序列组成的簇增长最高。在广义线性模型中，风险组（P<0.0001）、簇大小（P<0.0001）和亚型（P<0.01）可预测增长情况。