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HIV-1 subtypes and differences in heterosexual HIV transmission among HIV-discordant couples in Rakai, Uganda.

机译：乌干达拉凯的HIV-1亚型和异性恋HIV传播之间的差异。

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OBJECTIVE: To determine whether heterosexual transmission of HIV differs according to HIV-1 subtype. DESIGN: A retrospective observational cohort. METHODS: HIV-1 subtype effects on heterosexual HIV-1 transmission were determined among 268 HIV-discordant couples retrospectively identified from a population cohort in Rakai, Uganda. HIV-1 subtype (gag and gp41 sequencing and multiregion hybridization assay) and viral loads (reverse transcriptase PCR) were determined. Adjusted incidence rate ratios (adj IRR) of HIV transmission by subtype were estimated by multivariable Poisson regression adjusting for characteristics of index HIV-positive and HIV-negative partners. RESULTS: Adjusting for index HIV-positive partners' age, viral load, stage of disease, genital ulcer disease, and HIV-negative partners' genital ulcer disease and nonuse of condoms, subtype A viruses were associated with a higher rate of transmission than subtype D [adj.IRR 1.98, 95% confidence interval (CI) 1.17-3.34], but no differences in transmission were observed between recombinant viruses and subtype D (aIRR 1.53, P = 0.25). Index-positive partners' age less than 30 years (adj.IRR 3.44, 95% CI 1.75-6.78) and viral load (adj.IRR 2.37, 95% CI 1.75-3.21), and index-negative partners' genital ulcer disease (adj.IRR 1.71, 95% CI 1.08-2.70) and nonuse of condoms (adj.IRR 1.94, 95% CI 1.15-3.28) were significant determinants of HIV transmission. CONCLUSION: In Rakai, Uganda, subtype A viruses have a significantly higher rate of heterosexual transmission than subtype D viruses. Differential subtype transmission efficiency may be important for HIV vaccine evaluation and could contribute to subtype-specific HIV epidemics in sub-Saharan Africa.
机译：目的：确定HIV的异性传播是否因HIV-1亚型而异。设计：回顾性观察队列。方法：从乌干达拉凯市的一个人群中回顾性鉴定了268例HIV不一致夫妇中的HIV-1亚型对异性HIV-1传播的影响。确定了HIV-1亚型（gag和gp41测序和多区域杂交测定）和病毒载量（逆转录酶PCR）。通过对变量HIV阳性和HIV阴性伴侣的特征进行多变量Poisson回归估计，可以调整按亚型分类的HIV传播的调整后发生率（adj IRR）。结果：根据HIV阳性伴侣的年龄，病毒载量，疾病分期，生殖器溃疡疾病和HIV阴性伴侣的生殖器溃疡疾病以及不使用避孕套等指标进行调整后，A型病毒的传播率高于亚型D [调节IRR 1.98，95％置信区间（CI）1.17-3.34]，但在重组病毒和D亚型之间没有观察到传播差异（aIRR 1.53，P = 0.25）。阳性指标伙伴的年龄小于30岁（IRR为3.44,95％CI为1.75-6.78）和病毒载量（IRR 2.37,95％CI为1.75-3.21），阴性指标伙伴的生殖器溃疡病（ IRR 1.71，95％CI 1.08-2.70）和不使用安全套（IRR 1.94，95％CI 1.15-3.28）是HIV传播的重要决定因素。结论：在乌干达拉凯，A型病毒的异性传播率明显高于D型病毒。差异性亚型传播效率可能对评估HIV疫苗很重要，并且可能导致撒哈拉以南非洲亚型特定的HIV流行。

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