1. The Molecular Epidemiology and Transmission Dynamics of HIV Type 1 in a General Population Cohort in Uganda
- Author
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Rebecca N Nsubuga, Andrew J. Leigh Brown, Anne Kapaata, Janet Seeley, Deogratius Ssemwanga, Nicholas Bbosa, Gonzalo Yebra, Maria Nannyonjo, Faridah Nassolo, Alex Karabarinde, Joseph Mugisha, Pontiano Kaleebu, and Alfred Ssekagiri
- Subjects
0301 basic medicine ,Adult ,Male ,lcsh:QR1-502 ,Human immunodeficiency virus (HIV) ,General Population Cohort ,HIV Infections ,phylogeography ,medicine.disease_cause ,molecular epidemiology ,general population ,lcsh:Microbiology ,Article ,law.invention ,transmission networks ,subtype ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,law ,Virology ,parasitic diseases ,Medicine ,Cluster Analysis ,Humans ,Uganda ,030212 general & internal medicine ,demographic ,Phylogeny ,Molecular epidemiology ,business.industry ,Bayes Theorem ,Middle Aged ,Phylogeography ,030104 developmental biology ,Infectious Diseases ,Transmission (mechanics) ,HIV-1 ,bayesian ,RNA, Viral ,Female ,phylogenetic ,business ,Demography - Abstract
The General Population Cohort (GPC) in south-western Uganda has a low HIV-1 incidence rate (<, 1%). However, new infections continue to emerge. In this research, 3796 HIV-1 pol sequences (GPC: n = 1418, non-GPC sites: n = 1223, Central Uganda: n = 1010 and Eastern Uganda: n = 145) generated between 2003&ndash, 2015 were analysed using phylogenetic methods with demographic data to understand HIV-1 transmission in this cohort and inform the epidemic response. HIV-1 subtype A1 was the most prevalent strain in the GPC area (GPC and non-GPC sites) (39.8%), central (45.9%) and eastern (52.4%) Uganda. However, in the GPC alone, subtype D was the predominant subtype (39.1%). Of the 524 transmission clusters identified by Cluster Picker, all large clusters (&ge, 5 individuals, n = 8) involved individuals from the GPC. In a multivariate analysis, clustering was strongly associated with being female (adjusted Odds Ratio, aOR = 1.28, 95% CI, 1.06&ndash, 1.54), being >, 25 years (aOR = 1.52, 95% CI, 1.16&ndash, 2.0) and being a resident in the GPC (aOR = 6.90, 95% CI, 5.22&ndash, 9.21). Phylogeographic analysis showed significant viral dissemination (Bayes Factor test, BF >, 3) from the GPC without significant viral introductions (BF <, 3) into the GPC. The findings suggest localized HIV-1 transmission in the GPC. Intensifying geographically focused combination interventions in the GPC would contribute towards controlling HIV-1 infections.
- Published
- 2020
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