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Drivers of HIV-1 transmission: The Portuguese case
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Autores
Pineda-Peña, Andrea-Clemencia
Pingarilho, Marta
Li, Guangdi
Vrancken, Bram
Libin, Pieter
Gomes, Perpétua
Camacho, Ricardo Jorge
Theys, Kristof
Abecasis, Ana Barroso
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Fecha
2019
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Public Library of Science
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Abstract
Background Portugal has one of the most severe HIV-1 epidemics in Western Europe. Two subtypes circulate in parallel since the beginning of the epidemic. Comparing their transmission patterns and its association with transmitted drug resistance (TDR) is important to pinpoint transmission hotspots and to develop evidence-based treatment guidelines. Methods Demographic, clinical and genomic data were collected from 3599 HIV-1 naive patients between 2001 and 2014. Sequences obtained from drug resistance testing were used for subtyping, TDR determination and transmission clusters (TC) analyses. Results In Portugal, transmission of subtype B was significantly associated with young males, while transmission of subtype G was associated with older heterosexuals. In Portuguese originated people, there was a decreasing trend both for prevalence of subtype G and for number of TCs in this subtype. The active TCs that were identified (i.e. clusters originated after 2008) were associated with subtype B-infected males residing in Lisbon. TDR was significantly different when comparing subtypes B (10.8% [9.5–12.2]) and G (7.6% [6.4–9.0]) (p = 0.001). Discussion TC analyses shows that, in Portugal, the subtype B epidemic is active and fueled by young male patients residing in Lisbon, while transmission of subtype G is decreasing. Despite similar treatment rates for both subtypes in Portugal, TDR is significantly different between subtypes. © 2019 Pineda-Peña et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Keywords
Human immunodeficiency virus proteinase inhibitor , Highly Active , RNA directed DNA polymerase inhibitor , Adult , Age , Antiviral resistance , Article , Cohort analysis , Controlled study , Demography , Epidemic , Female , Genomics , Heterosexuality , Human , Human immunodeficiency virus 1 infection , Major clinical study , Male , Portugal , Portuguese (citizen) , Prevalence , Sex difference , Virus transmission , Drug effect , Follow up , Genetics , Genotype , Health survey , Highly active antiretroviral therapy , Human immunodeficiency virus 1 , Human immunodeficiency virus infection , Odds ratio , Sex factor , Socioeconomics , Virology , Young adult , Age Factors , Antiretroviral Therapy , Drug Resistance , Female , Follow-Up Studies , Genotype , HIV Infections , HIV-1 , Humans , Male , Odds Ratio , Portugal , Prevalence , Public Health Surveillance , Sex Factors , Socioeconomic Factors , Young Adult
