Unit:
Postgraduate Programme Biostatistics & Health Science DataLibrary of the School of Health Sciences
Author:
Panopoulou Ioanna
Supervisors info:
Δ. Παρασκευής, Επ. ΚΑθηγητής, Ιατρική, ΕΚΠΑ
Ε. Σαμόλη, Επ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Γ. Μαγιορκίνης, Λέκτορας, Ιατρική, ΕΚΠΑ
Original Title:
Φυλοδυναμική εκτίμηση κρίσιμων επιδημιολογικών παραμέτρων σε δίκτυα μεταδιδόμενης HIV-1 αντοχής σε μη θεραπευμένους οροθετικούς στην Ελλάδα με Μπεϋζιανή συμπερασματολογία
Translated title:
Phylodynamic estimation of critical epidemiological parameterers in transmission resistance networks in inutreated seropositive patients in greece with Bayesian Inference
Summary:
Background: Human immunodeficiency virus (HIV) is treated with a combinantion of antiretroviral drugs. The presence of resistance to antiretroviral drugs in drug naïve individuals increases the probability of virological failure. The most frequently observed sites associated with resisance to NNRTIs in drug naïve individuals in Greece are Κ103Ν, Ε138Α and Ε138Q. Previous studies have shown that subtype A strains with Ε138Α and Κ103Ν resistance mutations spread locally.
Aim: To investigate the transmission dynamic of subtype A and B strains with or without resistance mutations.
Material: We analyzed all the available subtype A and B sequenses isolated from drug naïve individuals in Greece during the period of 01/01/2003-30/06/2015. The analysis was carried out on randomly selected subsets of sequences for each subtype: i) five subsets in which no choice was made about the presence of resistance mutations on sequences (sample A), ii) five subsets with sequences with resistance mutations (sample B), iii) five subsets in which sequences with the most common resistance mutations (E138AQ and K103N) were excluded (sample C).
Methods: Subtype A and B transmission dynamics were estimated by using phylodynamic analysis. Specifically, phylodynamic analysis was performed on all subsets using birth-death models (BDM) on BEAST v1.8.0 program. BDM allowing the estimation of important epidemiological parameters such as the effective reproductive number (Re).
Results: Phylodynamic analyses revealed that there was no significant difference in the transmission rate of subtype A and B in the total sample (sample A). A significant decrease in the transimission rate of subtype B (median: 2.9) compared to subtype A (median: 5.2) over the period of 2002-2008 was observed for resistance strains (sample B). After the exclucion of the sequences with the most frequent resistance mutations (sample C), it was observed that the transmission rate of subtype A was 5.5 in the period of 2002-2008, and differed significally from the rate of subtype B which was 2.2 at the same period.
Conclusions: Τhe transmission dynamics of subtype A and B were similar among the drug naïve individuals. On the contrary, the dynamic of subtype A was higher than B for strains indentified with resistance mutations. This funding suggests that the subtype A resistant strains have been transmitted more efficiently than those of B, a conclusion that explains the higher prevelance of subtype A in Greece.
Main subject category:
Health Sciences
Keywords:
Phylodynamic, Resistance, Seropositive, Bayesian
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Panopoulou Ioanna Master.pdf
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