Transmission network parameters estimated from HIV sequences for a nationwide epidemic.

Transmission network parameters estimated from HIV sequences for a nationwide epidemic.
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DOI:
10.1093/infdis/jir550
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发表时间:
2011-11
期刊:
The Journal of infectious diseases
影响因子:
--
通讯作者:
UK HIV Drug Resistance Collaboration
UK HIV Drug Resistance Collaboration
中科院分区:
其他
文献类型:
--
作者:
Leigh Brown AJ;Lycett SJ;Weinert L;Hughes GJ;Fearnhill E;Dunn DT;UK HIV Drug Resistance Collaboration

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背景:许多关于性行为的研究表明,随着时间的推移,个体的性伴数量变化很大,但事实证明,除非在小规模接触者追踪研究中,否则很难获得与人类免疫缺陷病毒传播动力学有关的参数估计。 分子系统动力学的最新发展为获得这些参数估计提供了新的途径,目前的临床实践为整个感染人群提供了合适的数据。方法:对从14MSM560例患者中获得的部分 基因序列进行了系统动力学分析,这些患者约占英国接受治疗的男男性行为者中 阳性患者的60%。结果:在数据集中与其他人相关的个体中,29%只与1个个体相关,41%与2-10个个体相关,29%与≥10个个体相关。右偏度分布可以用幂定律来近似,但对于所有的时间深度,数据最好用瓦林分布来拟合。对于5-7年的时间深度,分布参数ρ位于表示无穷大变化的范围内。结论:英国男男性接触者之间的传播网络 具有优先关联性的特点,因此随机分布的干预不会被期望阻止流行。
Background. Many studies of sexual behavior have shown that individuals vary greatly in their number of sexual partners over time, but it has proved difficult to obtain parameter estimates relating to the dynamics of human immunodeficiency virus (HIV) transmission except in small-scale contact tracing studies. Recent developments in molecular phylodynamics have provided new routes to obtain these parameter estimates, and current clinical practice provides suitable data for entire infected populations. Methods. A phylodynamic analysis was performed on partial pol gene sequences obtained for routine clinical care from 14 560 individuals, representing approximately 60% of the HIV-positive men who have sex with men (MSM) under care in the United Kingdom. Results. Among individuals linked to others in the data set, 29% are linked to only 1 individual, 41% are linked to 2–10 individuals, and 29% are linked to ≥10 individuals. The right-skewed degree distribution can be approximated by a power law, but the data are best fitted by a Waring distribution for all time depths. For time depths of 5–7 years, the distribution parameter ρ lies within the range that indicates infinite variance. Conclusions. The transmission network among UK MSM is characterized by preferential association such that a randomly distributed intervention would not be expected to stop the epidemic.
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