Article

Guidelines for HIV in court cases.

Nature (Impact Factor: 42.35). 05/2011; 473(7347):284. DOI: 10.1038/473284a
Source: PubMed
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    ABSTRACT: OBJECTIVE: (s): To characterize HIV-1 epidemiological networks of men having sex with men (MSM) and drug users (DUs) in The Netherlands for over >30 years. DESIGN: and Methods: Previously we demonstrated different origin of the HIV-1 epidemics in Dutch MSM and DUs. To achieve the study objectives, risk group-specific genetic markers in the pol gene were examined in 315 participants of the Amsterdam Cohort Studies on HIV/AIDS who were registered as HIV-1-infected in 1981-2011. RESULTS:: Phylogenetic analysis demonstrated circulation of distinct virus strains in the two networks, with 98% of viruses of MSM clustering together and apart from strains of 73% DUs. Nine genetic markers that significantly distinguished virus strains specific for DUs were identified, of which three were ≥90% conserved. Over the total observation period, only 6% of viruses (4 of MSM and 14 of DUs) clustered with those of the other risk group. Among these sequences the three most conserved genetic markers of that other risk group were 87% conserved.All four cases of DU-specific viruses among MSM occurred in 1980s - early 1990s. Viruses non-specific for DUs were causing new infections among DUs at the rate of 20% till 2002, and replaced DU-specific strains among new infections thereafter, coinciding with switching of DUs to low harm drug practices. CONCLUSIONS:: Dutch MSM and DUs have remained separate epidemiological networks for decades, despite their geographical and behavioral overlap. Switching to low harm drug practices among DUs resulted in new infections caused by HIV-1 strains originating from other risk groups.
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