TY - JOUR
T1 - A Phylogenetic Analysis of Human Immunodeficiency Virus Type 1 Sequences in Kiev
T2 - Findings Among Key Populations
AU - Fearnhill, Esther
AU - Gourlay, Annabelle
AU - Malyuta, Ruslan
AU - Simmons, Ruth
AU - Ferns, R Bridget
AU - Grant, Paul
AU - Nastouli, Eleni
AU - Karnets, Iryna
AU - Murphy, Gary
AU - Medoeva, Antonia
AU - Kruglov, Yuri
AU - Yurchenko, Alexander
AU - Porter, Kholoud
AU - Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) Collaboration in EuroCoord
A2 - Lundgren, Jens Dilling
PY - 2017/10/1
Y1 - 2017/10/1
N2 - BACKGROUND: The human immunodeficiency virus (HIV) epidemic in Ukraine has been driven by a rapid rise among people who inject drugs, but recent studies have shown an increase through sexual transmission.METHODS: Protease and reverse transcriptase sequences from 876 new HIV diagnoses (April 2013-March 2015) in Kiev were linked to demographic data. We constructed phylogenetic trees for 794 subtype A1 and 64 subtype B sequences and identified factors associated with transmission clustering. Clusters were defined as ≥2 sequences, ≥80% local branch support, and maximum genetic distance of all sequence pairs in the cluster ≤2.5%. Recent infection was determined through the limiting antigen avidity enzyme immunoassay. Sequences were analyzed for transmitted drug resistance mutations.RESULTS: Thirty percent of subtype A1 and 66% of subtype B sequences clustered. Large clusters (maximum 11 sequences) contained mixed risk groups. In univariate analysis, clustering was significantly associated with subtype B compared to A1 (odds ratio [OR], 4.38 [95% confidence interval {CI}, 2.56-7.50]); risk group (OR, 5.65 [95% CI, 3.27-9.75]) for men who have sex with men compared to heterosexual males; recent, compared to long-standing, infection (OR, 2.72 [95% CI, 1.64-4.52]); reported sex work contact (OR, 1.93 [95% CI, 1.07-3.47]); and younger age groups compared with age ≥36 years (OR, 1.83 [95% CI, 1.10-3.05] for age ≤25 years). Females were associated with lower odds of clustering than heterosexual males (OR, 0.49 [95% CI, .31-.77]). In multivariate analysis, risk group, subtype, and age group were independently associated with clustering (P < .001, P = .007, and P = .033, respectively). Eighteen sequences (2.1%) indicated evidence of transmitted drug resistance.CONCLUSIONS: Our findings suggest high levels of transmission and bridging between risk groups.
AB - BACKGROUND: The human immunodeficiency virus (HIV) epidemic in Ukraine has been driven by a rapid rise among people who inject drugs, but recent studies have shown an increase through sexual transmission.METHODS: Protease and reverse transcriptase sequences from 876 new HIV diagnoses (April 2013-March 2015) in Kiev were linked to demographic data. We constructed phylogenetic trees for 794 subtype A1 and 64 subtype B sequences and identified factors associated with transmission clustering. Clusters were defined as ≥2 sequences, ≥80% local branch support, and maximum genetic distance of all sequence pairs in the cluster ≤2.5%. Recent infection was determined through the limiting antigen avidity enzyme immunoassay. Sequences were analyzed for transmitted drug resistance mutations.RESULTS: Thirty percent of subtype A1 and 66% of subtype B sequences clustered. Large clusters (maximum 11 sequences) contained mixed risk groups. In univariate analysis, clustering was significantly associated with subtype B compared to A1 (odds ratio [OR], 4.38 [95% confidence interval {CI}, 2.56-7.50]); risk group (OR, 5.65 [95% CI, 3.27-9.75]) for men who have sex with men compared to heterosexual males; recent, compared to long-standing, infection (OR, 2.72 [95% CI, 1.64-4.52]); reported sex work contact (OR, 1.93 [95% CI, 1.07-3.47]); and younger age groups compared with age ≥36 years (OR, 1.83 [95% CI, 1.10-3.05] for age ≤25 years). Females were associated with lower odds of clustering than heterosexual males (OR, 0.49 [95% CI, .31-.77]). In multivariate analysis, risk group, subtype, and age group were independently associated with clustering (P < .001, P = .007, and P = .033, respectively). Eighteen sequences (2.1%) indicated evidence of transmitted drug resistance.CONCLUSIONS: Our findings suggest high levels of transmission and bridging between risk groups.
KW - Adult
KW - Cluster Analysis
KW - Drug Resistance, Viral/genetics
KW - Female
KW - HIV Infections/epidemiology
KW - HIV-1/genetics
KW - Heterosexuality/physiology
KW - Homosexuality, Male/genetics
KW - Humans
KW - Male
KW - Phylogeny
KW - Sequence Analysis, DNA/methods
KW - Sexual and Gender Minorities
KW - Ukraine/epidemiology
U2 - 10.1093/cid/cix499
DO - 10.1093/cid/cix499
M3 - Journal article
C2 - 28575385
VL - 65
SP - 1127
EP - 1135
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 7
ER -