National surveillance of HIV-1 subtypes for England and Wales: design, methods, and initial findings.
The HIV-1 infections detected in an ongoing national unlinked anonymous HIV surveillance program were subtyped and analyzed according to demographic and risk characteristics. Of the 893 anti--HIV-1--positive specimens allocated to an exposure group, 70% could be subtyped. Almost 25% of infections subtyped were non-B, mostly subtypes A, C, and D. Non-B infections were rare in homosexual and bisexual men and in drug injectors. Forty percent of infections in heterosexual men attending genitourinary medicine clinics were non-B subtypes; of these, 25% were subtype A infections and 59% were subtype C infections. For female clinic attendees, 61% were non-B subtype infections, of which 48% were subtype A infections and 42% were subtype C infections. Of the clinic attendees born in the United Kingdom and Europe, 14% of the men and 35% of the women were infected with non-B subtypes. In contrast, 78% of infections in antenatal patients were non-B subtypes, of which 61% were subtype A and 29% were subtype C. Extrapolation to the estimated 29,700 prevalent adult infections in the United Kingdom indicates that approximately 8,100 (27%) such infections are non-B subtypes and that these are found almost entirely in heterosexuals. The findings suggest spread of infection of non-B subtypes to heterosexuals born in the United Kingdom from individuals infected in regions of high prevalence.
Parry
J V
JV
Sexually Transmitted and Blood Borne Virus Laboratory, Central Public Health Laboratory, London, United Kingdom.
Murphy
G
G
Barlow
K L
KL
Lewis
K
K
Rogers
P A
PA
Belda
F J
FJ
Nicoll
A
A
McGarrigle
C
C
Cliffe
S
S
Mortimer
P P
PP
Clewley
J P
JP
D000208:Acute Disease; D000328:Adult; D000465:Algorithms; D004739:England / Q000453:epidemiology; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D012703:Serotyping; D019529:Sexuality; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000821:virology; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000821:virology; D014852:Wales / Q000453:epidemiology
D012367:RNA, Viral