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Molecular phylodynamics of the heterosexual HIV epidemic in the United Kingdom.

ABSTRACT: The heterosexual risk group has become the largest HIV infected group in the United Kingdom during the last 10 years, but little is known of the network structure and dynamics of viral transmission in this group. The overwhelming majority of UK heterosexual infections are of non-B HIV subtypes, indicating viruses originating among immigrants from sub-Saharan Africa. The high rate of HIV evolution, combined with the availability of a very high density sample of viral sequences from routine clinical care has allowed the phylodynamics of the epidemic to be investigated for the first time. Sequences of the viral protease and partial reverse transcriptase coding regions from 11,071 patients infected with HIV of non-B subtypes were studied. Of these, 2774 were closely linked to at least one other sequence by nucleotide distance. Including the closest sequences from the global HIV database identified 296 individuals that were in UK-based groups of 3 or more individuals. There were a total of 8 UK-based clusters of 10 or more, comprising 143/2774 (5%) individuals, much lower than the figure of 25% obtained earlier for men who have sex with men (MSM). Sample dates were incorporated into relaxed clock phylogenetic analyses to estimate the dates of internal nodes. From the resulting time-resolved phylogenies, the internode lengths, used as estimates of maximum transmission intervals, had a median of 27 months overall, over twice as long as obtained for MSM (14 months), with only 2% of transmissions occurring in the first 6 months after infection. This phylodynamic analysis of non-B subtype HIV sequences representing over 40% of the estimated UK HIV-infected heterosexual population has revealed heterosexual HIV transmission in the UK is clustered, but on average in smaller groups and is transmitted with slower dynamics than among MSM. More effective intervention to restrict the epidemic may therefore be feasible, given effective diagnosis programmes.

SUBMITTER: Hughes GJ

PROVIDER: S-EPMC2742734 | biostudies-other | 2009 Sep

REPOSITORIES: biostudies-other

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Molecular phylodynamics of the heterosexual HIV epidemic in the United Kingdom.

Hughes Gareth J GJ Fearnhill Esther E Dunn David D Lycett Samantha J SJ Rambaut Andrew A Leigh Brown Andrew J AJ

PLoS pathogens 20090925 9

The heterosexual risk group has become the largest HIV infected group in the United Kingdom during the last 10 years, but little is known of the network structure and dynamics of viral transmission in this group. The overwhelming majority of UK heterosexual infections are of non-B HIV subtypes, indicating viruses originating among immigrants from sub-Saharan Africa. The high rate of HIV evolution, combined with the availability of a very high density sample of viral sequences from routine clinic ...[more]

PMID: 19779560

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Project description:INTRODUCTION:The view that we are in the midst of a global diabetes epidemic has gained considerable ground in recent years and is often linked to the prior 'obesity epidemic'. This research explored how the diabetes epidemic was represented in United Kingdom (UK) news over the same time period that the obesity epidemic was widely reported. The research was motivated by a sociological interest in how postmodern 'epidemics' synergise with each other amidst broader political, economic, moral and sociocultural discourses. METHOD:We analysed three time-bound samples of UK news articles about diabetes: 1993 (n = 19), 2001 (n = 119) and 2013 (n = 324). Until now, UK media has had the least attention regarding portrayal of diabetes. We adopted an empathically neutral approach and used a dual method approach of inductive thematic analysis and deductive framing analysis. The two methods were triangulated to produce the findings. RESULTS:Framing of diabetes moved from medical in 1993 to behavioural in 2001, then societal in 2013. By 2001 obesity was conceptualised as causal to diabetes, rather than a risk factor. Between 2001 and 2013 portrayals of the modifiable risk factors for diabetes (i.e. diet, exercise and weight) became increasingly technical. Other risk factors like age, family history and genetics faded during 2001 and 2013, while race, ethnicity and culture were positioned as states of 'high risk' for diabetes. The notion of an 'epidemic' of diabetes 'powered up' these concerns from an individual problem to a societal threat in the context of obesity as a well-known health risk. DISCUSSION AND CONCLUSION:Portraying diabetes and the diabetes epidemic as anticipated consequences of obesity enlivens the heightened awareness to future risks in everyday life brought about during the obesity epidemic. The freeform adoption of the 'epidemic' term in contemporary health discourse appears to foster individual and societal dependence on biomedicine, giving it political, economic and divisive utility.

Dataset Information

Molecular phylodynamics of the heterosexual HIV epidemic in the United Kingdom.

Publications

Molecular phylodynamics of the heterosexual HIV epidemic in the United Kingdom.

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