Gisselquist David, Collery Simon
Independent Researcher, Hershey, Pennsylvania, United States of America.
Borough of Camden, London, United Kingdom.
J Public Health Afr. 2025 Apr 30;16(1):715. doi: 10.4102/jphia.v16i1.715. eCollection 2025.
The consensus view that heterosexual transmission dominates human immunodeficiency viruses (HIV) epidemics in sub-Saharan Africa survives side-by-side with surveys and studies reporting infections in children with HIV-negative mothers, in virgins, and in adolescents and adults who claim no possible sexual exposure to HIV.
In this scoping review, we aim to show what phylogenetic analyses of HIV sequences say about the possible contribution of blood-borne transmission to HIV epidemics.
The focus was on sub-Saharan Africa.
The authors conducted a search on PubMed and other platforms for studies reporting phylogenetic analyses of HIV in blood samples collected from at least 100 infected adults through community-based surveys in sub-Saharan Africa. They focussed on identifying information pertinent to assessing blood-borne transmission.
Sixteen reports met the search criteria and provided information to assess blood-borne transmission. In five studies, similar HIV sequences from (reported or assumed) household couples identified a likely heterosexual source for 0.3% - 7.5% of community adults with sequenced HIV. In 10 studies, a median of 43% of sequence pairs linked two people of the same sex. Two studies report clusters of recent infections too large to be easily explained by sexual transmission.
Evidence from sequencing agrees with much other evidence that blood-borne HIV transmission is not rare in sub-Saharan Africa. Evidence also allows that blood-borne transmission could be making a major contribution to Africa's HIV epidemics.
Evidence of harm is sufficient to stimulate discussions about what more could be done to address this continuing problem.
在撒哈拉以南非洲地区，关于异性传播主导人类免疫缺陷病毒（HIV）流行的共识观点，与一些调查和研究并存。这些调查和研究报告称，HIV阴性母亲所生的儿童、处女以及声称没有可能接触HIV性途径的青少年和成年人感染了HIV。
在这项范围综述中，我们旨在展示HIV序列的系统发育分析对于血源性传播对HIV流行可能的贡献有何说法。
重点是撒哈拉以南非洲地区。
作者在PubMed和其他平台上进行搜索，查找通过撒哈拉以南非洲地区基于社区的调查，对至少100名受感染成年人采集的血液样本进行HIV系统发育分析的研究报告。他们专注于识别与评估血源性传播相关的信息。
16份报告符合搜索标准，并提供了评估血源性传播的信息。在5项研究中，来自（报告的或假设的）家庭伴侣的相似HIV序列表明，在进行HIV测序的社区成年人中，有0.3% - 7.5%可能源于异性传播。在10项研究中，中位数为43%的序列对将两名同性个体联系起来。两项研究报告了近期感染的聚集情况，其规模太大，难以通过性传播轻易解释。
测序证据与许多其他证据一致，即血源性HIV传播在撒哈拉以南非洲并不罕见。证据还表明，血源性传播可能对非洲的HIV流行有重大贡献。
危害证据足以激发关于如何进一步解决这一持续问题的讨论。
