Oster Alexandra M, Switzer William M, Hernandez Angela L, Saduvala Neeraja, Wertheim Joel O, Nwangwu-Ike Ndidi, Ocfemia M Cheryl, Campbell Ellsworth, Hall H Irene
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Ann Epidemiol. 2017 Apr;27(4):244-251.e1. doi: 10.1016/j.annepidem.2017.02.002. Epub 2017 Feb 22.
The aim of the analysis was to explore HIV-1 subtype diversity in the United States and understand differences in prevalence of non-B subtypes and circulating recombinant forms (CRFs) between demographic/risk groups and over time.
We included HIV-1 polymerase sequences reported to the National HIV Surveillance System for HIV infections diagnosed during 2006-2013 in seven states. We assigned subtype or CRF using the automated subtyping tool COMET, assessed subtype/CRF prevalence by demographic characteristics and country of birth, and determined changes in subtype/CRF by HIV diagnosis year.
Of 32,968 sequences, 30,757 (93.3%) were subtype B. The most common non-B subtypes and CRFs were C (1.6%), CRF02_AG (1.4%), A (0.6%), CRF01_AE (0.5%), and G (0.3%). Elevated percentages of non-B infections occurred among persons aged <13 years at diagnosis (40.9%), Asians (32.1%), persons born outside the United States (22.6%), and persons with infection attributable to heterosexual contact (12.0%-15.0%). Prevalence of non-B infections increased from 5.9% in 2006 to 8.5% in 2013.
Subtype B continues to predominate in the United States. However, the percentage of non-B infections has grown in recent years, and numerous demographic subgroups have much higher prevalence. Subgroups and areas with high prevalence of non-B infections might represent sub-epidemics meriting further investigation.
本分析旨在探索美国HIV-1亚型的多样性,并了解不同人口统计学/风险群体之间以及随时间推移非B亚型和循环重组型(CRF)流行率的差异。
我们纳入了2006年至2013年期间在七个州诊断出的HIV感染病例,并向国家HIV监测系统报告的HIV-1聚合酶序列。我们使用自动化分型工具COMET确定亚型或CRF,根据人口统计学特征和出生国家评估亚型/CRF的流行率,并根据HIV诊断年份确定亚型/CRF的变化情况。
在32968个序列中,30757个(93.3%)为B亚型。最常见的非B亚型和CRF为C型(1.6%)、CRF02_AG型(1.4%)、A型(0.6%)、CRF01_AE型(0.5%)和G型(0.3%)。诊断时年龄<13岁的人群(40.9%)、亚洲人(32.1%)、在美国境外出生的人(22.6%)以及因异性接触感染的人(12.0%-15.0%)中,非B感染的比例较高。非B感染的流行率从2006年的5.9%上升至2013年的8.5%。
在美国,B亚型仍然占主导地位。然而,近年来非B感染的比例有所上升,许多人口亚组的流行率更高。非B感染高流行率的亚组和地区可能代表值得进一步调查的子流行情况。