TY - JOUR
T1 - Phylogenetic analysis of the Belgian HIV-1 epidemic reveals that local transmission is almost exclusively driven by men having sex with men despite presence of large African migrant communities
AU - Verhofstede, Chris
AU - Dauwe, Kenny
AU - Fransen, Katrien
AU - Van Laethem, Kristel
AU - Van den Wijngaert, Sigi
AU - Ruelle, Jean
AU - Delforge, Marie-Luce
AU - Vancutsem, Ellen
AU - Vaira, Dolores
AU - Stoffels, Karolien
AU - Ribas, Sergio Garcia
AU - Dessilly, Geraldine
AU - Debaisieux, Laurent
AU - Pierard, Denis
AU - Van Ranst, Marc
AU - Hayette, Marie-Pierre
AU - Deblonde, Jessica
AU - Sasse, Andre
AU - Van Beckhoven, Dominique
AU - Mortier, Virginie
N1 - NPP
PY - 2018
Y1 - 2018
N2 - To improve insight in the drivers of local HIV-1 transmission in Belgium, phylogenetic, demographic, epidemiological and laboratory data from patients newly diagnosed between 2013 and 2015 were combined and analyzed. Characteristics of clustered patients, paired patients and patients on isolated branches in the phylogenetic tree were compared. The results revealed an overall high level of clustering despite the short time frame of sampling, with 47.6% of all patients having at least one close genetic counterpart and 36.6% belonging to a cluster of 3 or more individuals. Compared to patients on isolated branches, patients in clusters more frequently reported being infected in Belgium (95.1% vs. 47.6%; p <0.001), were more frequently men having sex with men (MSM) (77.9% vs. 42.8%; p <0.001), of Belgian origin (68.2% vs. 32.9%; p <0.001), male gender (92.6% vs. 65.8%; p <0.001), infected with subtype B or F (87.8% vs. 43.4%; p <0.001) and diagnosed early after infection (55.4% vs. 29.0%; p <0.001). Strikingly, Sub-Saharan Africans (SSA), overall representing 27.1% of the population were significantly less frequently found in clusters than on individual branches (6.0% vs. 41.8%; p <0.001). Of the SSA that participated in clustered transmission, 66.7% were MSM and this contrasts sharply with the overall 12.0% of SSA reporting MSM. Transmission clusters with SSA were more frequently non-B clusters than transmission clusters without SSA (44.4% versus 18.2%). MSM-driven clusters with patients of mixed origin may account, at least in part, for the increasing spread of non-B subtypes to the native MSM population, a cross-over that has been particularly successful for subtype F and CRF02-AG.The main conclusions from this study are that clustered transmission in Belgium remains almost exclusively MSM-driven with very limited contribution of SSA. There were no indications for local ongoing clustered transmission of HIV-1 among SSA.
AB - To improve insight in the drivers of local HIV-1 transmission in Belgium, phylogenetic, demographic, epidemiological and laboratory data from patients newly diagnosed between 2013 and 2015 were combined and analyzed. Characteristics of clustered patients, paired patients and patients on isolated branches in the phylogenetic tree were compared. The results revealed an overall high level of clustering despite the short time frame of sampling, with 47.6% of all patients having at least one close genetic counterpart and 36.6% belonging to a cluster of 3 or more individuals. Compared to patients on isolated branches, patients in clusters more frequently reported being infected in Belgium (95.1% vs. 47.6%; p <0.001), were more frequently men having sex with men (MSM) (77.9% vs. 42.8%; p <0.001), of Belgian origin (68.2% vs. 32.9%; p <0.001), male gender (92.6% vs. 65.8%; p <0.001), infected with subtype B or F (87.8% vs. 43.4%; p <0.001) and diagnosed early after infection (55.4% vs. 29.0%; p <0.001). Strikingly, Sub-Saharan Africans (SSA), overall representing 27.1% of the population were significantly less frequently found in clusters than on individual branches (6.0% vs. 41.8%; p <0.001). Of the SSA that participated in clustered transmission, 66.7% were MSM and this contrasts sharply with the overall 12.0% of SSA reporting MSM. Transmission clusters with SSA were more frequently non-B clusters than transmission clusters without SSA (44.4% versus 18.2%). MSM-driven clusters with patients of mixed origin may account, at least in part, for the increasing spread of non-B subtypes to the native MSM population, a cross-over that has been particularly successful for subtype F and CRF02-AG.The main conclusions from this study are that clustered transmission in Belgium remains almost exclusively MSM-driven with very limited contribution of SSA. There were no indications for local ongoing clustered transmission of HIV-1 among SSA.
KW - HIV-1 transmission
KW - HIV-1 in Belgium
KW - Men who have sex with men
KW - Phylogenetic clustering
KW - HIV-1 in Sub-Saharan African migrants
KW - NON-B SUBTYPES
KW - NEWLY-DIAGNOSED PATIENTS
KW - MOLECULAR EPIDEMIOLOGY
KW - DRUG-RESISTANCE
KW - SPATIOTEMPORAL DYNAMICS
KW - ANTIRETROVIRAL THERAPY
KW - EUROPEAN COUNTRIES
KW - INFECTION
KW - CLUSTERS
KW - TYPE-1
U2 - 10.1016/j.meegid.2018.03.002
DO - 10.1016/j.meegid.2018.03.002
M3 - A1: Web of Science-article
SN - 1567-1348
VL - 61
SP - 36
EP - 44
JO - Infection, Genetics and Evolution
JF - Infection, Genetics and Evolution
ER -