HIV-1 transmission networks in high risk fishing communities on the shores of Lake Victoria in Uganda: A phylogenetic and epidemiological approach
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A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
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Date
2017-10-01
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en
Pages
1-23
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PLoS ONE, Volume 12, issue 10
Abstract
Background: Fishing communities around Lake Victoria in sub-Saharan Africa have been characterised as a population at high risk of HIV-infection. Methods: Using data from a cohort of HIV-positive individuals aged 13–49 years, enrolled from 5 fishing communities on Lake Victoria between 2009–2011, we sought to identify factors contributing to the epidemic and to understand the underlying structure of HIV transmission networks. Clinical and socio-demographic data were combined with HIV-1 phylogenetic analyses. HIV-1 gag-p24 and env-gp-41 sub-genomic fragments were amplified and sequenced from 283 HIV-1-infected participants. Phylogenetic clusters with 2 highly related sequences were defined as transmission clusters. Logistic regression models were used to determine factors associated with clustering. Results: Altogether, 24% (n = 67/283) of HIV positive individuals with sequences fell within 34 phylo-genetically distinct clusters in at least one gene region (either gag or env). Of these, 83% occurred either within households or within community; 8/34 (24%) occurred within household partnerships, and 20/34 (59%) within community. 7/12 couples (58%) within households clustered together. Individuals in clusters with potential recent transmission (11/34) were more likely to be younger 71% (15/21) versus 46% (21/46) in un-clustered individuals and had recently become resident in the community 67% (14/21) vs 48% (22/46). Four of 11 (36%) potential transmission clusters included incident-incident transmissions. Independently, clustering was less likely in HIV subtype D (adjusted Odds Ratio, aOR = 0.51 [95% CI 0.26–1.00]) than A and more likely in those living with an HIV-infected individual in the household (aOR = 6.30 [95% CI 3.40–11.68]). Conclusions: A large proportion of HIV sexual transmissions occur within house-holds and within communities even in this key mobile population. The findings suggest localized HIV transmissions and hence a potential benefit for the test and treat approach even at a community level, coupled with intensified HIV counselling to identify early infections.Description
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Kiwuwa-Muyingo, S, Nazziwa, J, Ssemwanga, D, Ilmonen, P, Njai, H, Ndembi, N, Parry, C, Kitandwe, P K, Gershim, A, Mpendo, J, Neilsen, L, Seeley, J, Seppälä, H, Lyagoba, F, Kamali, A & Kaleebu, P 2017, ' HIV-1 transmission networks in high risk fishing communities on the shores of Lake Victoria in Uganda : A phylogenetic and epidemiological approach ', PloS one, vol. 12, no. 10, e0185818, pp. 1-23 . https://doi.org/10.1371/journal.pone.0185818