Transmission of non-B HIV subtypes in the UK is increasingly driven by large non-heterosexual clusters

UK HIV Drug Resistance Database; Manon Ragonnet-Cronin; Samantha Lycett; Emma Hodcroft; Stéphane Hué; Esther Fearnhill; Alison E Brown; Valerie Delpech; David Dunn; Andrew J Leigh Brown

doi:10.1093/infdis/jiv758

Transmission of non-B HIV subtypes in the UK is increasingly driven by large non-heterosexual clusters

UK HIV Drug Resistance Database, Manon Ragonnet-Cronin, Samantha Lycett, Emma Hodcroft, Stéphane Hué, Esther Fearnhill, Alison E Brown, Valerie Delpech, David Dunn, Andrew J Leigh Brown

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: In the UK HIV epidemic, historically dominated by subtype B transmission among men who have sex with men (MSM), 50% of diagnoses and prevalent infections are now heterosexual, mainly non-B subtypes. Between 2002 and 2010 non-B diagnoses among MSM increased from 5.4% to 17% and this study has 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 UK HIV Drug Resistance Database was analysed by risk group.

RESULTS: Of 1148 clusters containing at least two 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 ≥7, being highest for clusters comprising sequences from MSM and people who inject drugs (PWID). Risk group (p<0.0001), cluster size (p<0.0001) and subtype (p<0.01) 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 UK.

Original language	English
Pages (from-to)	1410-1418
Journal	The Journal of Infectious Diseases
Volume	213
Issue number	9
Early online date	23 Dec 2015
DOIs	https://doi.org/10.1093/infdis/jiv758
Publication status	E-pub ahead of print - 23 Dec 2015

Keywords / Materials (for Non-textual outputs)

HIV
Clusters
Phylogenetics
Subtypes
MSM
PWID
Heterosexual
Crossover
Phylogeny
Epidemiology

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10.1093/infdis/jiv758

J Infect Dis.-2015-Ragonnet-Cronin-infdis-jiv758Final published version, 471 KB

Modelling Epidemic Infectious Diseases Using Sequence Analysis
Leigh-Brown, A. (Principal Investigator)
Non-EU other
1/05/14 → 30/04/15
Project: Research
Phylogenetics Networks to Address Tranmission of HIV
Leigh-Brown, A. (Principal Investigator)
Other
18/10/13 → 30/09/17
Project: Research

Andrew Leigh-Brown
- School of Biological Sciences - Professor of Evolutionary Genetics
Person: Academic: Research Active

Cite this

UK HIV Drug Resistance Database, Ragonnet-Cronin, M., Lycett, S., Hodcroft, E., Hué, S., Fearnhill, E., Brown, A. E., Delpech, V., Dunn, D., & Leigh Brown, A. J. (2015). Transmission of non-B HIV subtypes in the UK is increasingly driven by large non-heterosexual clusters. The Journal of Infectious Diseases, 213(9), 1410-1418. Advance online publication. https://doi.org/10.1093/infdis/jiv758

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title = "Transmission of non-B HIV subtypes in the UK is increasingly driven by large non-heterosexual clusters",

abstract = "BACKGROUND: In the UK HIV epidemic, historically dominated by subtype B transmission among men who have sex with men (MSM), 50% of diagnoses and prevalent infections are now heterosexual, mainly non-B subtypes. Between 2002 and 2010 non-B diagnoses among MSM increased from 5.4% to 17% and this study has 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 UK HIV Drug Resistance Database was analysed by risk group.RESULTS: Of 1148 clusters containing at least two 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 ≥7, being highest for clusters comprising sequences from MSM and people who inject drugs (PWID). Risk group (p<0.0001), cluster size (p<0.0001) and subtype (p<0.01) 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 UK.",

keywords = "HIV, Clusters, Phylogenetics, Subtypes, MSM, PWID, Heterosexual, Crossover, Phylogeny, Epidemiology",

author = "{UK HIV Drug Resistance Database} and Manon Ragonnet-Cronin and Samantha Lycett and Emma Hodcroft and St{\'e}phane Hu{\'e} and Esther Fearnhill and Brown, {Alison E} and Valerie Delpech and David Dunn and {Leigh Brown}, {Andrew J}",

note = "{\textcopyright} The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.",

year = "2015",

month = dec,

day = "23",

doi = "10.1093/infdis/jiv758",

language = "English",

volume = "213",

pages = "1410--1418",

journal = "The Journal of Infectious Diseases",

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TY - JOUR

T1 - Transmission of non-B HIV subtypes in the UK is increasingly driven by large non-heterosexual clusters

AU - UK HIV Drug Resistance Database

AU - Ragonnet-Cronin, Manon

AU - Lycett, Samantha

AU - Hodcroft, Emma

AU - Hué, Stéphane

AU - Fearnhill, Esther

AU - Brown, Alison E

AU - Delpech, Valerie

AU - Dunn, David

AU - Leigh Brown, Andrew J

N1 - © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

PY - 2015/12/23

Y1 - 2015/12/23

N2 - BACKGROUND: In the UK HIV epidemic, historically dominated by subtype B transmission among men who have sex with men (MSM), 50% of diagnoses and prevalent infections are now heterosexual, mainly non-B subtypes. Between 2002 and 2010 non-B diagnoses among MSM increased from 5.4% to 17% and this study has 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 UK HIV Drug Resistance Database was analysed by risk group.RESULTS: Of 1148 clusters containing at least two 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 ≥7, being highest for clusters comprising sequences from MSM and people who inject drugs (PWID). Risk group (p<0.0001), cluster size (p<0.0001) and subtype (p<0.01) 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 UK.

AB - BACKGROUND: In the UK HIV epidemic, historically dominated by subtype B transmission among men who have sex with men (MSM), 50% of diagnoses and prevalent infections are now heterosexual, mainly non-B subtypes. Between 2002 and 2010 non-B diagnoses among MSM increased from 5.4% to 17% and this study has 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 UK HIV Drug Resistance Database was analysed by risk group.RESULTS: Of 1148 clusters containing at least two 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 ≥7, being highest for clusters comprising sequences from MSM and people who inject drugs (PWID). Risk group (p<0.0001), cluster size (p<0.0001) and subtype (p<0.01) 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 UK.

KW - HIV

KW - Clusters

KW - Phylogenetics

KW - Subtypes

KW - MSM

KW - PWID

KW - Heterosexual

KW - Crossover

KW - Phylogeny

KW - Epidemiology

U2 - 10.1093/infdis/jiv758

DO - 10.1093/infdis/jiv758

M3 - Article

C2 - 26704616

SN - 0022-1899

VL - 213

SP - 1410

EP - 1418

JO - The Journal of Infectious Diseases

JF - The Journal of Infectious Diseases

IS - 9

ER -

Transmission of non-B HIV subtypes in the UK is increasingly driven by large non-heterosexual clusters

Abstract

Keywords / Materials (for Non-textual outputs)

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Modelling Epidemic Infectious Diseases Using Sequence Analysis

Phylogenetics Networks to Address Tranmission of HIV

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Andrew Leigh-Brown

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