The multi-faceted dynamics of HIV-1 transmission in Northern Alberta: A combined analysis of virus genetic and public health data.
The multi-faceted dynamics of HIV-1 transmission in Northern Alberta: A combined analysis of virus genetic and public health data.
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艾伯塔省北部 HIV-1 传播的多方面动态：病毒遗传和公共卫生数据的综合分析。
DOI：
10.1016/j.meegid.2017.04.005
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Julian W. Tang
中科院分区：
文献类型：
--
作者：
B. Vrancken;Dena Adachi;Marlin Benedet;Ameeta E. Singh;R. Read;Stephen D. Shafran;Geoffrey Taylor;Kimberley Simmonds;C. Sikora;Philippe Lemey;Carmen L. Charlton;Julian W. Tang
分子流行病学已成为追踪传染病流行的关键工具。在这里，加拿大北方阿尔伯塔最流行的HIV-1亚型的传播特征是使用贝叶斯系统发育方法，使用2007年至2013年期间收集的1146个HIV-1 pol序列进行常规临床管理。可用的患者元数据进行定性解释，并与向前传输使用Fisher精确检验和逻辑回归。感染以A亚型（n = 36）、B亚型（n = 815）和C亚型（n = 211）为主。非洲是亚型A和C的主要起源地，而亚型B流行是从美国和中美洲开始的，从20世纪90年代初开始，主要是通过跨省传播。亚型A（77.8%）和C（74.0%）通常是异性性传播，主要在黑人中传播（分别为61.1%和85%）。亚型B主要见于高加索人（48.6%）和原住民（36.8%），其传播方式按种族来源分层。与亚型A（5.6%）和C（3.8-10.0%）相比，亚型B患者的大部分被发现在假定的省级传播网络（20.3-29.5%），这几乎翻了一番时，集中在全国范围内的传播集群（37.9-57.5%）。集群成员和特定的患者characteristics之间没有明确的关联found. This研究揭示了复杂的和多方面的传播动态的HIV-1的流行，否则在北方阿尔伯塔，加拿大的艾滋病流行率低的人口。这些发现可以帮助公共卫生规划。
Molecular epidemiology has become a key tool for tracking infectious disease epidemics. Here, the spread of the most prevalent HIV-1 subtypes in Northern Alberta, Canada, was characterized with a Bayesian phylogenetic approach using 1146 HIV-1 pol sequences collected between 2007 and 2013 for routine clinical management purposes. Available patient metadata were qualitatively interpreted and correlated with onwards transmission using Fisher exact tests and logistic regression. Most infections were from subtypes A (n = 36), B (n = 815) and C (n = 211). Africa is the dominant origin location for subtypes A and C while the subtype B epidemic was seeded from the USA and Middle America and, from the early 1990s onwards, mostly by interprovincial spread. Subtypes A (77.8%) and C (74.0%) were usually heterosexually transmitted and circulate predominantly among Blacks (61.1% and 85% respectively). Subtype B was mostly found among Caucasians (48.6%) and First Nations (36.8%), and its modes of transmission were stratified by ethnic origin. Compared to subtypes A (5.6%) and C (3.8–10.0%), a larger portion of subtype B patients were found within putative provincial transmission networks (20.3–29.5%), and this almost doubled when focusing on nationwide transmission clusters (37.9–57.5%). No clear association between cluster membership and particular patient characteristics was found. This study reveals complex and multi-faceted transmission dynamics of the HIV-1 epidemic in this otherwise low HIV prevalence population in Northern Alberta, Canada. These findings can aid public health planning.
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影响因子：
10.7
作者：
O'Brien, John D.;Minin, Vladimir N.;Suchard, Marc A.
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