American Journal of Epidemiology, Vol 152, Issue 9 814-822, Copyright © 2000 by Oxford University Press
C Kuiken, R Thakallapalli, A Esklid and A de Ronde
The extreme variability of human immunodeficiency virus type 1 (HIV-1)
makes it possible to conduct transmission studies on the basis of genetic
analysis and to trace global and local patterns in the spread of the virus.
Two such patterns are discussed in this paper. First, in many European
countries (e.g., Scotland and Germany), homosexual men tend to be infected
with a subtly different variant of HIV-1 than intravenous drug users. In
other European countries (e.g., Norway and Sweden), a distinction is also
found between the two risk groups; but based on available data, the
distinction is a different one. The second pattern is a worldwide tendency
for homosexual men in many different geographic regions around the world to
carry HIV-1 subtype B, the variant that is most prevalent in the Americas,
Europe, and Australia. In contrast, people infected via other routes
(mostly heterosexual contact) in those same countries carry a mixture of
other subtypes. Biologic differences between the viruses infecting
different risk groups have not been found; the most likely explanation for
the findings is different epidemiologic patterns. Although data are still
scarce, the authors attempt to use these patterns in the reconstruction of
the worldwide spread of the HIV epidemic.
Genetic analysis reveals epidemiologic patterns in the spread of human immunodeficiency virus [In Process Citation]
Los Alamos National Laboratory, NM 87545, USA. kuiken@lanl.gov
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