Abstract
ABSTRACT
Background
Portugal has one of the most severe HIV-1 epidemic 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
3599 HIV-1 naive patients collected between 2001 and 2014 were included
in the study. Sequences obtained from drug resistance testing were used for
subtyping, TDR determination and transmission clusters (TC)
analyses.
Results
Subtype B transmission was significantly associated with young males,
while subtype G was associated with older heterosexuals. Young males
infected with subtype B were more likely to be included in TC. Consistently,
a decreasing trend of prevalence and transmission of subtype G in Portuguese
originated people was observed. Active TCs 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 the subtype B epidemic is active and fueled by
young male patients residing in Lisbon and that transmission of subtype G in
Portugal is decreasing. Despite similar treatment rates for both subtypes in
Portugal, TDR is different between subtypes.
Publisher
Cold Spring Harbor Laboratory
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