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Molecular epidemiology of HIV-1 in the United Kingdom.

Hue, S.; (2005) Molecular epidemiology of HIV-1 in the United Kingdom. Doctoral thesis , University of London. Green open access

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Abstract

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.

Type: Thesis (Doctoral)
Title: Molecular epidemiology of HIV-1 in the United Kingdom.
Identifier: PQ ETD:593689
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by Proquest Third party copyright material has been removed from the e-thesis.
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: http://discovery.ucl.ac.uk/id/eprint/1446342
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