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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

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Abstract
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.
Keywords
NON-B SUBTYPES, NEWLY-DIAGNOSED PATIENTS, MOLECULAR EPIDEMIOLOGY, DRUG-RESISTANCE, SPATIOTEMPORAL DYNAMICS, ANTIRETROVIRAL THERAPY, EUROPEAN COUNTRIES, INFECTION, CLUSTERS, TYPE-1, HIV-1 transmission, HIV-1 in Belgium, Men who have sex with men, Phylogenetic clustering, HIV-1 in Sub-Saharan African migrants

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MLA
Verhofstede, Chris, Kenny Dauwe, Katrien Fransen, et al. “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.” INFECTION GENETICS AND EVOLUTION 61 (2018): 36–44. Print.
APA
Verhofstede, C., Dauwe, K., Fransen, K., Van Laethem, K., Van den Wijngaert, S., Ruelle, J., Delforge, M.-L., et al. (2018). 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. INFECTION GENETICS AND EVOLUTION, 61, 36–44.
Chicago author-date
Verhofstede, Chris, Kenny Dauwe, Katrien Fransen, Kristel Van Laethem, Sigi Van den Wijngaert, Jean Ruelle, Marie-Luce Delforge, et al. 2018. “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.” Infection Genetics and Evolution 61: 36–44.
Chicago author-date (all authors)
Verhofstede, Chris, Kenny Dauwe, Katrien Fransen, Kristel Van Laethem, Sigi Van den Wijngaert, Jean Ruelle, Marie-Luce Delforge, Ellen Vancutsem, Dolores Vaira, Karolien Stoffels, Sergio Garcia Ribas, Geraldine Dessilly, Laurent Debaisieux, Denis Pierard, Marc Van Ranst, Marie-Pierre Hayette, Jessica Deblonde, Andre Sasse, Dominique Van Beckhoven, and Virginie Mortier. 2018. “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.” Infection Genetics and Evolution 61: 36–44.
Vancouver
1.
Verhofstede C, Dauwe K, Fransen K, Van Laethem K, Van den Wijngaert S, Ruelle J, et al. 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. INFECTION GENETICS AND EVOLUTION. 2018;61:36–44.
IEEE
[1]
C. Verhofstede et al., “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,” INFECTION GENETICS AND EVOLUTION, vol. 61, pp. 36–44, 2018.
@article{8576522,
  abstract     = {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.},
  author       = {Verhofstede, Chris and Dauwe, Kenny and Fransen, Katrien and Van Laethem, Kristel and Van den Wijngaert, Sigi and Ruelle, Jean and Delforge, Marie-Luce and Vancutsem, Ellen and Vaira, Dolores and Stoffels, Karolien and Garcia Ribas, Sergio and Dessilly, Geraldine and Debaisieux, Laurent and Pierard, Denis and Van Ranst, Marc and Hayette, Marie-Pierre and Deblonde, Jessica and Sasse, Andre and Van Beckhoven, Dominique and Mortier, Virginie},
  issn         = {1567-1348},
  journal      = {INFECTION GENETICS AND EVOLUTION},
  keywords     = {NON-B SUBTYPES,NEWLY-DIAGNOSED PATIENTS,MOLECULAR EPIDEMIOLOGY,DRUG-RESISTANCE,SPATIOTEMPORAL DYNAMICS,ANTIRETROVIRAL THERAPY,EUROPEAN COUNTRIES,INFECTION,CLUSTERS,TYPE-1,HIV-1 transmission,HIV-1 in Belgium,Men who have sex with men,Phylogenetic clustering,HIV-1 in Sub-Saharan African migrants},
  language     = {eng},
  pages        = {36--44},
  title        = {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},
  url          = {http://dx.doi.org/10.1016/j.meegid.2018.03.002},
  volume       = {61},
  year         = {2018},
}

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