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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Phylogenetic analyses reveal HIV-1 infections between men misclassified as heterosexual transmissions
AIDS, Volume 28, No. 13, Year 2014
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Description
Objective: HIV-1 subtype B infections are associated with MSM in the UK. Yet, around 13% of subtype B infections are found in those reporting heterosexual contact as transmission route. Using phylogenetics, we explored possible misclassification of sexual exposure among men diagnosed with HIV in the UK. Design: Viral gene sequences linked to patient-derived information were used to identify phylogenetic transmission chains. Methods: A total of 22 481 HIV-1 subtype B pol gene sequences sampled between 1996 and 2008 were analysed. Dated phylogenies were reconstructed and transmission clusters identified as clades of at least two sequences with a maximum genetic distance of 4.5%, a branch support of at least 95% and spanning 5 years. The characteristics of clusters containing at least one heterosexually acquired infection were analysed. Results: Twenty-nine percent of the linked heterosexuals clustered exclusively with MSM. These were more likely to be men than women. Estimated misclassification of homosexually acquired infections ranged between 1 and 11% of the reported male heterosexuals diagnosed with HIV. Black African heterosexual men were more often phylogenetically linked to MSM than other ethnic group, with an estimated misclassification range between 1 and 21%. Conclusion: Overall, a small proportion of self-reported heterosexual men diagnosed with HIV could have been infected homosexually. However, up to one in five black African heterosexual men chose not to disclose sex with men at HIV diagnosis and preferred to be identified as heterosexual. Phylogenetic analyses can enhance surveillance-based risk information and inform national programmes for monitoring and preventing HIV infections. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Hué, Stéphane
United Kingdom, London
University College London
Brown, Alison E.
United Kingdom, London
Public Health England
Ragonnet-Cronin, Manon L.
United Kingdom, Edinburgh
The University of Edinburgh
Lycett, Samantha J.
United Kingdom, Edinburgh
The University of Edinburgh
United Kingdom, Glasgow
University of Glasgow
Dunn, David T.
United Kingdom, London
Medical Research Council
Fearnhill, Esther
United Kingdom, London
Medical Research Council
Dolling, David I.
United Kingdom, London
Medical Research Council
Pozniak, Anton Louis
United Kingdom, London
Chelsea and Westminster Hospital
Morris, Lynn G.
United Kingdom, London
University College London
Delpech, Valerie C.
United Kingdom, London
Public Health England
Leigh Brown, Andrew J.
United Kingdom, Edinburgh
The University of Edinburgh
Statistics
Citations: 68
Authors: 11
Affiliations: 6
Identifiers
Doi:
10.1097/QAD.0000000000000383
ISSN:
02699370
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Participants Gender
Male
Female