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首页> 外文期刊>Infection, Genetics and Evolution: Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases >Epidemiological network analysis in HIV-1 B infected patients diagnosed in Italy between 2000 and 2008.
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Epidemiological network analysis in HIV-1 B infected patients diagnosed in Italy between 2000 and 2008.

机译：2000年至2008年之间在意大利诊断出的HIV-1 B感染患者的流行病学网络分析。

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This study, through a phylogenetic analysis, is aimed to identify potential epidemiological networks and sequence interrelationships between acute/early and chronic infections in both drug-naive and drug-experienced individuals within a local, well-defined setting and to investigate the population dynamics of transmitted resistance and the potential contribution of untreated patients to the spread of antiretroviral resistance. A total of 884 HIV-1 B subtype pol gene sequences from 306 drug-naive (40 recently and 266 chronically infected) and 578 drug-treated HIV-1 infected patients were collected through routine drug-resistance testing between 2000 and 2008 in a single center (Division of Infectious Disease, Bergamo, Northern Italy). Bayesian phylogenetic tree was reconstructed and transmission clusters were recognized using a posterior probability as statistical support of each cluster. Differences among clustered and non-clustered drug-resistance mutations were assessed by Fisher's exact test. In our cohort we identified five clusters including >=6 sequences with the root posterior probability of 100%. Dated phylogenies reconstructed through Bayesian Markov chain Monte Carlo model was possible for only two main clade (>=10 sequences) originated between 1990 and 2002. Among the 306 drug-naive individuals, 12% carried a viral strain with at least 1 major mutation associated with transmitted drug resistance and 36% of these strains were involved in significant clusters. We report for the first time that many (34%) of HIV-1 subtype B transmission clusters identified in Italy were only composed by drug-naive individuals and that the 14% of transmitted drug resistance was linked to transmission clusters composed only of newly diagnosed individuals. The phylogenetic analysis was performed on a large cohort of drug-naive recently/chronically infected individuals where drug-experienced patients represent almost all infected individuals in a restricted geographical area. Our findings highlight the role of newly diagnosed individuals, not yet exposed to antiretroviral drugs, in the transmission of drug-resistant HIV-1 strains, providing new insights for the planning and management of treatment programs in developing countries. Copyright Copyright 2011 Elsevier B.V. All rights reserved.
机译：这项研究通过系统发育分析，旨在确定未感染者和有经验的个体在本地，定义明确的环境中潜在的流行病学网络和急性/早期和慢性感染之间的序列相互关系，并调查该人群的种群动态。传播的耐药性以及未经治疗的患者对抗逆转录病毒耐药性传播的潜在贡献。通过2000年至2008年之间的常规耐药性检测，共收集了306个单纯药物（最近40个，慢性感染266个）和578个药物治疗的HIV-1感染患者的884个HIV-1 B亚型pol基因序列。中心（意大利北部贝加莫市传染病科）。重建贝叶斯系统树，并使用后验概率作为每个群集的统计支持来识别传输群集。通过Fisher精确检验评估了群集和非群集耐药性突变之间的差异。在我们的队列中，我们确定了五个聚类，包括> = 6个序列，根后验概率为100％。通过贝叶斯马尔可夫链蒙特卡洛模型重建的日期系统学仅适用于1990年至2002年之间产生的两个主要进化枝（> = 10序列）。在306名未使用过药物的个体中，有12％携带了带有至少1个主要突变的病毒株具有耐药性，这些菌株中有36％参与了重要的集群。我们首次报告，在意大利鉴定出的许多（34％）HIV-1 B型亚型传播群仅由未经药物治疗的个体组成，而14％的传播抗药性与仅由新诊断出的传播群有关个人。系统发育分析是对一大批未经药物治疗的新近/长期感染的个体进行的，其中受过药物治疗的患者几乎代表了受限地理区域内的所有感染者。我们的研究结果突显了尚未暴露于抗逆转录病毒药物的新诊断个体在耐药HIV-1毒株传播中的作用，为发展中国家治疗计划的规划和管理提供了新见识。版权版权所有2011 Elsevier B.V.保留所有权利。

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