Population dynamics of HIV-2 in rural Guinea-Bissau: comparison with HIV-1 and ongoing transmission at the heart of the epidemic.

de Silva, TI; van Tienen, C; Onyango, C; Jabang, A; Vincent, T; Loeff, MF; Coutinho, RA; Jaye, A; Rowland-Jones, S; Whittle, H; Cotten, M; Hué, S; (2012) Population dynamics of HIV-2 in rural Guinea-Bissau: comparison with HIV-1 and ongoing transmission at the heart of the epidemic. AIDS (London, England). ISSN 0269-9370 DOI: https://doi.org/10.1097/QAD.0b013e32835ab12c

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OBJECTIVES:: To compare the population dynamics of HIV-2 and HIV-1, and to characterise ongoing HIV-2 transmission in rural Guinea-Bissau. DESIGN:: Phylogenetic and phylodynamic analyses using HIV-2 gag and env, and HIV-1 env sequences, combined with epidemiological data from a community cohort. METHODS:: Samples were obtained from surveys in 1989-1991, 1996-1997, 2003 and 2006-2007. Phylogenies were reconstructed using sequences from 103 HIV-2 infected and 56 HIV-1 infected subjects using BEAST, a relaxed molecular clock and a Bayesian skyline coalescent model. RESULTS:: Bayesian skyline plots showed a strong increase in the 1990s of the HIV-1 effective population size (Ne) in the same period that the Ne of HIV-2 came into a plateau phase. The population dynamics of both viruses were remarkably similar following initial introduction. Incident infections were found more often in HIV-2 transmission clusters, with 55-58% of all individuals contributing to ongoing transmission. Some phylogenetically-linked sexual partners had discordant viral loads (undetectable vs detectable), suggesting host factors dictate the risk of disease progression in HIV-2. Multiple HIV-2 introductions into the cohort are evident, but ongoing transmission has occurred predominantly within the community. CONCLUSIONS:: Comparison of HIV-1 and HIV-2 phylodynamics in the same community suggests both viruses followed similar growth patterns following introduction and is consistent with the hypothesis that HIV-1 may have played a role in the decline of HIV-2 via competitive exclusion. The source of ongoing HIV-2 transmission in the cohort appears to be new HIV-2 cases, rather than the pool of older infections established during the early growth of HIV-2.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 23032414
Web of Science ID: 312358000015
URI: http://researchonline.lshtm.ac.uk/id/eprint/313004


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