期刊
AIDS
卷 28, 期 13, 页码 1967-1975出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000000383
关键词
heterosexual transmission; HIV; molecular epidemiology; MSM; phylogenetics
资金
- Medical Research Council [G0900274]
- Department of Health
- University College London Hospitals Biomedical Research Centre
- Collaborative HIV and Anti-HIV Drug Resistance Network (CHAIN)
- Wellcome Trust [092807]
- Biotechnology and Biological Science Research Council (MR-C)
- Boehringer Ingelheim
- Bristol-Myers Squibb
- Gilead
- Tibotec (a division of Janssen-Cilag)
- Roche
- MRC [MC_UU_12023/15, G0900274] Funding Source: UKRI
- Biotechnology and Biological Sciences Research Council [1098048] Funding Source: researchfish
- Medical Research Council [MC_UU_12023/15, G0900274] Funding Source: researchfish
Objective: HIV-1 subtype B infections are associated with MSM in the UK. Yet, around 13% of subtype B infections are found in those reporting heterosexual contact as transmission route. Using phylogenetics, we explored possible misclassification of sexual exposure among men diagnosed with HIV in the UK. Design: Viral gene sequences linked to patient-derived information were used to identify phylogenetic transmission chains. Methods: A total of 22 481 HIV-1 subtype B pol gene sequences sampled between 1996 and 2008 were analysed. Dated phylogenies were reconstructed and transmission clusters identified as clades of at least two sequences with a maximum genetic distance of 4.5%, a branch support of at least 95% and spanning 5 years. The characteristics of clusters containing at least one heterosexually acquired infection were analysed. Results: Twenty-nine percent of the linked heterosexuals clustered exclusively with MSM. These were more likely to be men than women. Estimated misclassification of homosexually acquired infections ranged between 1 and 11% of the reported male heterosexuals diagnosed with HIV. Black African heterosexual men were more often phylogenetically linked to MSM than other ethnic group, with an estimated misclassification range between 1 and 21%. Conclusion: Overall, a small proportion of self-reported heterosexual men diagnosed with HIV could have been infected homosexually. However, up to one in five black African heterosexual men chose not to disclose sex with men at HIV diagnosis and preferred to be identified as heterosexual. Phylogenetic analyses can enhance surveillance- based risk information and inform national programmes for monitoring and preventing HIV infections. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
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