Evidence for onward transmission of HIV-1 non-B subtype strains in the United Kingdom
Evidence for onward transmission of HIV-1 non-B subtype strains in the United Kingdom
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DOI：
10.1097/01.qai.0000179430.34660.11
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发表时间：
2006-02-01
影响因子：
3.6
通讯作者：
Easterbrook, PJ
中科院分区：
文献类型：
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作者：
Aggarwal, I;Smith, M;Easterbrook, PJ
在联合王国和其他欧洲国家，越来越多的新的艾滋病毒诊断可归因于非B亚型感染，主要是在非洲黑人中，他们是在萨巴拉以南非洲通过异性性行为感染的。我们研究了在南伦敦一个种族多样的HIV-1感染队列中是否有非B亚型向前传播的证据。384例在国王学院医院就诊的HIV-1感染患者使用内部酶联免疫测定和env测序进行亚型分型。流行病学数据来自病历审查和患者的医生，并用于确定最可能的感染源和国家。总体而言，344例患者（154例非洲黑人，148例英国出生的白色和42例加勒比黑人）具有可识别的亚型。非B亚型在非洲黑人、白色和加勒比黑人患者中的患病率分别为96.8%、14.2%和31%。大多数非B亚型感染是在非洲黑人中发现的（183例中有149例），主要是在撒哈拉以南非洲获得的，但22.9%（183例中有42例）的非B亚型感染可能是在英国获得的。在21例感染非B亚型的英国出生的白色患者中，15例可能在英国感染，其中只有6例报告了来自艾滋病毒流行地区的源性伴侣。所有13名非B感染的加勒比黑人患者最有可能在联合王国感染，其中大多数（13名患者中有8名）可能是被来自艾滋病毒流行地区的伴侣感染的。在联合王国，非B感染的非洲黑人患者的潜在艾滋病毒感染率最低，这些感染中的大多数可能是从来自艾滋病毒流行地区的伴侣那里获得的。这项研究提供了第一个证据，证明非B亚型在英国，特别是在加勒比黑人人口中的传播。
An increasing proportion of new HIV diagnoses in the United Kingdom and other European countries are attributable to non-B subtype infections, mainly among black Africans with infections heterosexually acquired in sub-Sabaran Africa. We examined whether there was evidence for onward transmission of non-B subtypes within an ethnically diverse HIV-1-infected cohort in South London. Three hundred eighty-four HIV-1-infected patients attending Kings College Hospital were subtyped using an in-house enzyme-linked immunoassay and env sequencing. Epidemiologic data were obtained from medical chart review and the patients' physician and were used to establish the most likely source and country of infection. Overall, 344 patients (154 black African, 148 white UK-born, and 42 black Caribbean) had an identifiable subtype. The prevalence of non-B subtypes among the black African, white, and black Caribbean patients was 96.8%, 14.2%, and 31%, respectively. Most non-B subtype infections were identified in black Africans (149 of 183 cases) and were mainly acquired in sub-Saharan Africa, but 22.9% (42 of 183 cases) of all non-B infections were probably acquired in the United Kingdom. Among the 21 white UK-bom patients infected with a non-B subtype, 15 probably acquired the infection in the United Kingdom and only 6 of these patients reported a source sexual partner from an HIV endemic area. All 13 black Caribbean patients with a non-B infection most likely acquired their infection in the United Kingdom, most of whom (8 of 13 patients) were probably infected by a partner from an HIV endemic area. Potential acquisition of HIV infection in the United Kingdom was lowest among black African patients with a non-B infection, and most of these infections were probably acquired from a partner originating from an HIV endemic area. This study provides the first evidence for onward transmission of non-B subtypes in the United Kingdom, particularly among the black Caribbean population.