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Transmission of Non-B HIV Subtypes in the United Kingdom Is Increasingly Driven by Large Non-Heterosexual Transmission Clusters
- Source :
- The Journal of Infectious Diseases
- Publication Year :
- 2015
- Publisher :
- Oxford University Press, 2015.
-
Abstract
- Background. The United Kingdom human immunodeficiency virus (HIV) epidemic was historically dominated by HIV subtype B transmission among men who have sex with men (MSM). Now 50% of diagnoses and prevalent infections are among heterosexual individuals and mainly involve non-B subtypes. Between 2002 and 2010, the prevalence of non-B diagnoses among MSM increased from 5.4% to 17%, and this study focused on the drivers of this change. Methods. Growth between 2007 and 2009 in transmission clusters among 14 000 subtype A1, C, D, and G sequences from the United Kingdom HIV Drug Resistance Database was analysed by risk group. Results. Of 1148 clusters containing at least 2 sequences in 2007, >75% were pairs and >90% were heterosexual. Most clusters (71.4%) did not grow during the study period. Growth was significantly lower for small clusters and higher for clusters of ≥7 sequences, with the highest growth observed for clusters comprising sequences from MSM and people who inject drugs (PWID). Risk group (P < .0001), cluster size (P < .0001), and subtype (P < .01) were predictive of growth in a generalized linear model. Discussion. Despite the increase in non-B subtypes associated with heterosexual transmission, MSM and PWID are at risk for non-B infections. Crossover of subtype C from heterosexuals to MSM has led to the expansion of this subtype within the United Kingdom.
- Subjects :
- 0301 basic medicine
Male
medicine.medical_specialty
HIV Infections
Drug resistance
phylogeny
Men who have sex with men
law.invention
03 medical and health sciences
Major Articles and Brief Reports
law
Epidemiology
Immunology and Allergy
Medicine
Cluster Analysis
Humans
clusters
MSM
Homosexuality, Male
PWID
crossover
Molecular Epidemiology
Molecular epidemiology
Non-heterosexual
business.industry
Incidence (epidemiology)
subtypes
Incidence
HIV
Virology
United Kingdom
3. Good health
phylogenetics
030104 developmental biology
Infectious Diseases
Transmission (mechanics)
heterosexual
Heterosexuality
HIV-1
HIV/AIDS
epidemiology
business
Subjects
Details
- Language :
- English
- ISSN :
- 15376613 and 00221899
- Volume :
- 213
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- The Journal of Infectious Diseases
- Accession number :
- edsair.doi.dedup.....21b6ae09156fa9d100014ada039abcab