Identification of major routes of HIV transmission throughout Mesoamerica.

Autor: Chaillon A; University of California, San Diego, La Jolla, CA, USA., Avila-Ríos S; Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico., Wertheim JO; University of California, San Diego, La Jolla, CA, USA., Dennis A; University of North Carolina, Chapel Hill, NC, USA., García-Morales C; Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico., Tapia-Trejo D; Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico., Mejía-Villatoro C; Infectious Diseases Clinic, Roosevelt Hospital, Guatemala City, Guatemala., Pascale JM; Gorgas Memorial Institute for Health Studies, Panama City, Panama., Porras-Cortés G; Vivian Pellas Metropolitan Hospital, Managua, Nicaragua., Quant-Durán CJ; Roberto Calderón Hospital, Managua, Nicaragua., Lorenzana I; National Autonomous University of Honduras, Tegucigalpa, Honduras., Meza RI; Honduras National Reference HIV Laboratory, Tegucigalpa, Honduras., Palou EY; University School Hospital, Tegucigalpa, Honduras., Manzanero M; Ministry of Health, Belmopan, Belize., Cedillos RA; Rosales National Hospital, San Salvador, El Salvador., Reyes-Terán G; Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico. Electronic address: gustavo.reyesteran@gmail.com., Mehta SR; University of California, San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA. Electronic address: srmehta@ucsd.edu.
Jazyk: angličtina
Zdroj: Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases [Infect Genet Evol] 2017 Oct; Vol. 54, pp. 98-107. Date of Electronic Publication: 2017 Jun 20.
DOI: 10.1016/j.meegid.2017.06.021
Abstrakt: Background: Migration and travel are major drivers of the spread of infectious diseases. Geographic proximity and a common language facilitate travel and migration in Mesoamerica, which in turn could affect the spread of HIV in the region.
Methods: 6092 HIV-1 subtype B partial pol sequences sampled from unique antiretroviral treatment-naïve individuals from Mexico (40.7%), Guatemala (24.4%), Honduras (19%), Panama (8.2%), Nicaragua (5.5%), Belize (1.4%), and El Salvador (0.7%) between 2011 and 2016 were included. Phylogenetic and genetic network analyses were performed to infer putative relationships between HIV sequences. The demographic and geographic associations with clustering were analyzed and viral migration patterns were inferred using the Slatkin-Maddison approach on 100 iterations of random subsets of equal number of sequences per location.
Results: A total of 1685/6088 (27.7%) of sequences linked with at least one other sequence, forming 603 putative transmission clusters (range: 2-89 individuals). Clustering individuals were significantly more likely to be younger (median age 29 vs 33years, p<0.01) and men-who-have-sex-with-men (40.4% vs 30.3%, p<0.01). Of the 603 clusters, 30 (5%) included sequences from multiple countries with commonly observed linkages between Mexican and Honduran sequences. Eight of the 603 clusters included >10 individuals, including two comprised exclusively of Guatemalans (52 and 89 individuals). Phylogenetic and migration analyses suggested that the Central and Southern regions of Mexico along with Belize were major sources of HIV throughout the region (p<0.01) with genetic flow southward from Mexico to the other nations of Mesoamerica. We also found evidence of significant viral migration within Mexico.
Conclusion: International clusters were infrequent, suggesting moderate migration between HIV epidemics of the different Mesoamerican countries. Nevertheless, we observed important sources of transnational HIV spread in the region, including Southern and Central Mexico and Belize.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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