Molecular Epidemiology Reveals Long-Term Changes in HIV Type 1 Subtype B Transmission in Switzerland
Molecular Epidemiology Reveals Long-Term Changes in HIV Type 1 Subtype B Transmission in Switzerland
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DOI：
10.1086/651951
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发表时间：
2010-05-15
影响因子：
6.4
通讯作者：
Guenthard, Huldrych F.
中科院分区：
文献类型：
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作者：
Kouyos, Roger D.;von Wyl, Viktor;Guenthard, Huldrych F.
背景。来自耐药测试的序列数据为描述人类免疫缺陷病毒（HIV）感染流行的结构提供了独特的机会。我们分析了瑞士HIV队列研究中5700名患者的HIV 1型（HIV-1）亚型B pol序列的代表性集合。我们将这些序列与来自国外流行病的相同数量的序列进行汇总，推断出一个系统发育，并将瑞士传播集群确定为最小大小为10且包含>= 80%瑞士序列的进化支。超过一半的瑞士患者被包括在60个传播聚集群中。大多数传播聚类明显以特定的传播途径为主，用于确定以下患者群体：男男性行为者（MSM）（38个传播聚类，平均聚类大小为29例）或通过异性接触（HETs）和注射吸毒者（IDUs）感染艾滋病毒的患者（12个传播聚类，平均聚类大小为144例）。有趣的是，没有仅由HETs序列主导的传播集群。尽管在1983年至1986年期间，44%的艾滋病毒感染者与注射吸毒者聚集在一起，但在2003年至2006年期间，这一比例降至18% (P < 0.001)，表明注射吸毒者在艾滋病毒感染者之间传播中的作用随着时间的推移而减弱。我们的分析表明(1)在瑞士HETs中HIV-1亚型B没有自我维持的流行；(2)HETs和注射吸毒者中HIV感染的聚集性暂时下降。
Background. Sequence data from resistance testing offer unique opportunities to characterize the structure of human immunodeficiency virus (HIV) infection epidemics.Methods. We analyzed a representative set of HIV type 1 (HIV-1) subtype B pol sequences from 5700 patients enrolled in the Swiss HIV Cohort Study. We pooled these sequences with the same number of sequences from foreign epidemics, inferred a phylogeny, and identified Swiss transmission clusters as clades having a minimal size of 10 and containing >= 80% Swiss sequences.Results. More than one-half of Swiss patients were included within 60 transmission clusters. Most transmission clusters were significantly dominated by specific transmission routes, which were used to identify the following patient groups: men having sex with men (MSM) (38 transmission clusters; average cluster size, 29 patients) or patients acquiring HIV through heterosexual contact (HETs) and injection drug users (IDUs) (12 transmission clusters; average cluster size, 144 patients). Interestingly, there were no transmission clusters dominated by sequences from HETs only. Although 44% of all HETs who were infected between 1983 and 1986 clustered with injection drug users, this percentage decreased to 18% for 2003-2006 (P < .001), indicating a diminishing role of injection drug users in transmission among HETs over time.Conclusions. Our analysis suggests (1) the absence of a self-sustaining epidemic of HIV-1 subtype B in HETs in Switzerland and (2) a temporally decreasing clustering of HIV infections in HETs and IDUs.