HIV-1 subtype in Scotland: the establishment of a national surveillance system

Abstract

Historically, subtype B viruses in men who have sex with men (MSM) and injecting drug users (IDU) dominated the HIV epidemic in the United Kingdom, whereas non-B heterosexual infections dominate globally. Heterosexual contact is now the most common route of transmission in the United Kingdom. Here we monitor HIV subtype in Scotland, and link it to origin of infection. HIV-1 sequence was generated from new diagnoses and the subtype thus obtained linked with demographic data. Virus was subtyped from 80% (137/171) of all new diagnoses in Scotland. Of 58 individuals infected by heterosexual contact, 74% (43) harboured non-B viruses, contrasting with 7% (5/68) of those infected by IDU or MSM. Eighty-four per cent of non-Bs (46/55) were probably acquired outside the United Kingdom, but nine individuals probably acquired their non-B infection in the United Kingdom. Non-B subtypes of HIV-1 predominate in recently diagnosed, heterosexually acquired infections in Scotland and are present in all risk groups, even those with no exposure outside the United Kingdom.

Non-B HIV Type 1 Subtypes among Men Who Have Sex with Men in Rome, Italy

“…[30][31][32] Also in France among the MSM with a new HIV-1 diagnosis the highest proportion of recent infections (46.0%) and an elevated percentage of non-B subtypes (12.0%), after 2003, have been observed. 19 Nevertheless, there are relatively few data on HIV-1 genetic diversity among MSM in Europe, and most of the available data have been provided by national surveillance systems 33,34 or from serosurveys of individuals attending HIV-1 screening programs in urban STI clinics. The overall percentage of non-B subtypes in our cohort (13.5%) is higher than the percentage reported in some northern European countries, which range from 4% to 12%, [17][18][19]34 although it is not even half of that observed in Greece.…”

“…19 Nevertheless, there are relatively few data on HIV-1 genetic diversity among MSM in Europe, and most of the available data have been provided by national surveillance systems 33,34 or from serosurveys of individuals attending HIV-1 screening programs in urban STI clinics. The overall percentage of non-B subtypes in our cohort (13.5%) is higher than the percentage reported in some northern European countries, which range from 4% to 12%, [17][18][19]34 although it is not even half of that observed in Greece. 5 The percentage of non-B infections in our study is higher than that found in previous studies conducted in Italy among MSM, heterosexual contacts, and IDUs, 13,[36][37][38][39] yet it is similar to that of another study, 40 reflecting the increasing circulation of non-B subytpes in the general population.…”

Genotypic Variation in thepolGene of HIV Type 1 in an Antiretroviral Treatment-Naive Population in Rural Southwestern Uganda

“…As ARVs are becoming more readily available throughout the world this imbalance must be addressed such that there is sufficient knowledge accrued to decide whether all subtypes can be considered equal in terms of response to treatment and in development and transmission of drug resistance. Furthermore, in Europe infections with non-B subtypes are being detected with increasing frequency 5 (Gifford et al, submitted), making knowledge of subtype differences pertinent to both the developed and developing world.…”

Novel subtype C human immunodeficiency virus type 1 envelopes cloned directly from plasma: coreceptor usage and neutralization phenotypes

“…Here, we analysed Envs from infections acquired in six African countries and from Scotland, UK. Our replicationcompetent viruses with new Envs represent a diverse range of contemporary subtype C isolates for which we have determined coreceptor usage and sensitivity to neutralizing antibodies.Plasma samples were obtained from 13 HIV-1 subtype C infected, treatment naive individuals diagnosed in Scotland through the National Surveillance System (Yirrell et al, 2004). The undisclosed patients' origins and viral loads are presented in Supplementary Table S1 (available in JGV Online).…”

“…Plasma samples were obtained from 13 HIV-1 subtype C infected, treatment naive individuals diagnosed in Scotland through the National Surveillance System (Yirrell et al, 2004). The undisclosed patients' origins and viral loads are presented in Supplementary Table S1 (available in JGV Online).…”