HIV infection is now the fastest-growing serious health hazard in the United Kingdom (UK), with an estimated 53,000 infected adults at the end of 2003. Despite a recent increase in heterosexually acquired infections, the most prevalent clade of virus within the country remains subtype B, from the main group of HIV-1, which is mainly transmitted through sex between men. To date, very little is known about how subtype B successfully invaded the British population, and how the virus has subsequently spread and evolved. Given that molecular data on HIV-1 is becoming increasingly available since the introduction of routine gene sequencing for drug-resistance monitoring, the present thesis proposes to assess the reliability of the HIV-1 pol gene for molecular analyses of epidemiological relevance. Identification of transmission networks by phylogenetic means were primarily conducted, with the further goal to investigate the dynamics of HIV-1 transmission at both individual and population level in the UK. Evolutionary and epidemiological approaches were then combined in order to assess the correlates of transmission within a population of primary HIV-1 infected individuals within a localised risk group, exploiting both molecular and clinical data. Finally, the epidemic history of HIV-1 subtype B in the UK was reconstructed from sampled HIV-1 pol gene sequences, providing new insights into the complexity of HIV- 1 epidemics that must be considered when developing monitoring and prevention initiatives. The analyses presented in these pages emphasizes the advantage of combining state-of-the-art epidemiological studies to phylogenetic frameworks when investigating the dynamics of a viral epidemic as complex as HIV-1.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:684739 |
| Date | January 2005 |
| Creators | Hue, S. |
| Publisher | University College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://discovery.ucl.ac.uk/1446342/ |
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