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
[en] 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.
Disciplines :
Immunology & infectious disease
Author, co-author :
Verhofstede, Chris
Dauwe, Kenny
Fransen, Katrien
Van Laethem, Kristel
Van Den Wijngaert, Sigi
Ruelle, Jean
Delforge, Marie-Luce
Vancutsem, Ellen
VAIRA, Dolorès ; Centre Hospitalier Universitaire de Liège - CHU > Service de microbiologie clinique
Stoffels, Karolien
Garcia Ribas, Sergio
Dessilly, Géraldine
Debaisieux, Laurent
Piérard, Denis
Van Ranst, Marc
Hayette, Marie-Pierre ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Bactériologie, mycologie, parasitologie, virologie
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
Alternative titles :
[en] L'analyse philogénétique de l'épidémie HIV1 en Belgique révèle que la transmission locale est presque exclusivement due aux homosexuels de sexe masculin malgré la présence d'une grande communauté africaine
Publication date :
March 2018
Journal title :
Infection, Genetics and Evolution: Journal of Molecular Epidemiology and Evolutionary Genetics of Infectious Diseases
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