Identification of risk factors associated with national transmission and late presentation of HIV-1, Denmark, 2009 to 2017

Background Despite availability of pre-exposure prophylaxis (PrEP), the incidence of HIV-1 in Europe remained stable the past decade. Reduction of new HIV-1 infections requires more knowledge about the profiles of high-risk transmitters and late presenters (LP). Aim We aimed to investigate risk factors associated with HIV-1 transmission clusters and late presentation with HIV-1 in Denmark. Methods Blood samples and epidemiological information were collected from newly diagnosed HIV-1 patients between 2009 and 2017. We genotyped pol genes and performed phylogenetic analyses to identify clusters. Risk factors for clustering and LP were investigated with partial proportional odds and logistic regression. Covariates included transmission mode, HIV-1 subtype, age, origin and cluster activity. Results We included 1,040 individuals in the analysis, 59.6% identified with subtype B and 48.4% in a cluster. Risk factors for clustering included Danish origin (odds ratio (OR): 2.95; 95% confidence interval (CI): 2.21–3.96), non-LP (OR: 1.44; 95% CI: 1.12–1.86), and men who have sex with men (MSM). Increasing age and non-B subtype infection decreased risk (OR: 0.69; 95% CI: 0.50–0.94). Risk for late presentation was lower for active clusters (OR: 0.60; 95% CI: 0.44–0.82) and Danish origin (OR: 0.43; 95% CI: 0.27–0.67). Non-Danish MSM had a lower risk than non-Danish heterosexuals (OR: 0.34; 95% CI: 0.21–0.55). Conclusion HIV-1 transmission in Denmark is driven by early diagnosed, young, subtype B infected MSM. These may benefit most from PrEP. Non-Danish heterosexual HIV-1 patients could benefit from improved communication to achieve earlier diagnosis and treatment.

Download Full-text

82. HIV Risk Factors Associated With The Pre-Exposure Prophylaxis Cascade Among Young And Adult Black Men Who Have Sex With Men In Baltimore City

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2018.10.097 ◽

2019 ◽

Vol 64 (2) ◽

pp. S44

Author(s):

Errol L. Fields ◽

Christina Fennell ◽

Jessica Wagner ◽

Christina Schumacher ◽

Aruna Chandran ◽

...

Keyword(s):

Risk Factors ◽

Black Men ◽

Hiv Risk ◽

Baltimore City ◽

Factors Associated ◽

Sex With Men ◽

Exposure Prophylaxis ◽

Hiv Risk Factors

Download Full-text

Determinants of HIV-1 late presentation in a cohort of Portuguese HIV-1 patients

10.1101/2020.06.17.20133785 ◽

2020 ◽

Author(s):

Ana Cláudia Miranda ◽

Mafalda Miranda ◽

Marta Pingarilho ◽

Victor Pimentel ◽

João Torres ◽

...

Keyword(s):

Late Presentation ◽

Sub Saharan Africa ◽

Hiv Care ◽

Late Presenters ◽

Factors Associated ◽

Exposure Category ◽

Undiagnosed Hiv ◽

Hiv Exposure ◽

Sub Saharan ◽

Hiv 1

AbstractBackgroundUndiagnosed HIV-1 patients still account for 25% of worldwide HIV patients. Studying late presenters for HIV care may help to identify characteristics of such patients.ObjectiveThe present study aims to identify factors associated with late presentation (LP) and late presentation with advanced disease (LPAD) based on a population of patients followed in a Portuguese hospital between 1984 and 2017.MethodsSociodemographic and clinical data from infected patients with HIV-1 aged 18 years and older, followed in Egas Moniz Hospital, in Portugal were collected.ResultsOf the 907 patients included in this study, 68.7% were males and the median age was 37 years (IQR 30-47). 459 patients (50.6%) were LP and, of these, 284 patients (61.9%) were LPAD. The LP population mostly originated from Portugal and Sub-Saharan Africa (64.4% and 28.8%; p=0.004) and the HIV exposure category mainly heterosexuals and MSM (57.0% and 24.9%; p<0.001). The stage of disease and viral load at diagnosis were significantly associated with both LP and LPAD (p<0.001). Factors associated with LP in the logistic regression included age at diagnosis lower than 30y (aOR 0.34; 0.17-0.68; p=0.002) and origin from Sub-Saharan Africa (aOR 2.24; 1.44-3.50; p<0.001).ConclusionLate presentation is a major obstacle to halt the HIV epidemic. In this population, the majority of newly diagnosed HIV-infected individuals were late presenters. Our results characterize vulnerable populations that should be frequently tested for HIV.

Download Full-text

Genetic Diversity and Drug Resistance of HIV-1 CRF55_01B in Guangdong, China

Current HIV Research ◽

10.2174/1570162x18666200415140652 ◽

2020 ◽

Vol 18 (3) ◽

pp. 210-218

Author(s):

Guolong Yu ◽

Yan Li ◽

Xuhe Huang ◽

Pingping Zhou ◽

Jin Yan ◽

...

Keyword(s):

Genetic Diversity ◽

Drug Resistance ◽

Reverse Transcriptase ◽

Phylogenetic Analyses ◽

Resistance Mutations ◽

Protease Inhibition ◽

Subtype B ◽

Primary Drug Resistance ◽

Hiv 1 ◽

Primary Drug

Background: HIV-1 CRF55_01B was first reported in 2013. At present, no report is available regarding this new clade’s polymorphisms in its functionally critical regions protease and reverse transcriptase. Objective: To identify the diversity difference in protease and reverse transcriptase between CRF55_01B and its parental clades CRF01_AE and subtype B; and to investigate CRF55_01B’s drug resistance mutations associated with the protease inhibition and reverse transcriptase inhibition. Methods: HIV-1 RNA was extracted from plasma derived from a MSM population. The reverse transcription and nested PCR amplification were performed following our in-house PCR procedure. Genotyping and drug resistant-associated mutations and polymorphisms were identified based on polygenetic analyses and the usage of the HIV Drug Resistance Database, respectively. Results: A total of 9.24 % of the identified CRF55_01B sequences bear the primary drug resistance. CRF55_01B contains polymorphisms I13I/V, G16E and E35D that differ from those in CRF01_AE. Among the 11 polymorphisms in the RT region, seven were statistically different from CRF01_AE’s. Another three polymorphisms, R211K (98.3%), F214L (98.3%), and V245A/E (98.3 %.), were identified in the RT region and they all were statistically different with that of the subtype B. The V179E/D mutation, responsible for 100% potential low-level drug resistance, was found in all CRF55_01B sequences. Lastly, the phylogenetic analyses demonstrated 18 distinct clusters that account for 35% of the samples. Conclusions: CRF55_01B’s pol has different genetic diversity comparing to its counterpart in CRF55_01B’s parental clades. CRF55_01B has a high primary drug resistance presence and the V179E/D mutation may confer more vulnerability to drug resistance.

Download Full-text

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

Pathogens ◽

10.3390/pathogens10070835 ◽

2021 ◽

Vol 10 (7) ◽

pp. 835

Author(s):

Mafalda N. S. Miranda ◽

Marta Pingarilho ◽

Victor Pimentel ◽

Maria do Rosário O. Martins ◽

Anne-Mieke Vandamme ◽

...

Keyword(s):

Late Presentation ◽

World Health ◽

Prevention Measures ◽

Demographic Information ◽

Late Presenters ◽

Major Threat ◽

Immunodeficiency Virus ◽

Mode Of Transmission ◽

Health Organization ◽

Hiv 1

To control the Human Immunodeficiency Virus (HIV) pandemic, the World Health Organization (WHO) set the 90-90-90 target to be reached by 2020. One major threat to those goals is late presentation, which is defined as an individual presenting a TCD4+ count lower than 350 cells/mm3 or an AIDS-defining event. The present study aims to identify determinants of late presentation in Europe based on the EuResist database with HIV-1 infected patients followed-up between 1981 and 2019. Our study includes clinical and socio-demographic information from 89851 HIV-1 infected patients. Statistical analysis was performed using RStudio and SPSS and a Bayesian network was constructed with the WEKA software to analyze the association between all variables. Among 89,851 HIV-1 infected patients included in the analysis, the median age was 33 (IQR: 27.0–41.0) years and 74.4% were males. Of those, 28,889 patients (50.4%) were late presenters. Older patients (>56), heterosexuals, patients originated from Africa and patients presenting with log VL >4.1 had a higher probability of being late presenters (p < 0.001). Bayesian networks indicated VL, mode of transmission, age and recentness of infection as variables that were directly associated with LP. This study highlights the major determinants associated with late presentation in Europe. This study helps to direct prevention measures for this population.

Download Full-text

Impact of genotypic diversity on selection of subtype-specific drug resistance profiles during raltegravir-based therapy in individuals infected with B and BF recombinant HIV-1 strains

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkaa042 ◽

2020 ◽

Vol 75 (6) ◽

pp. 1567-1574

Author(s):

Daniela Sánchez ◽

Solange Arazi Caillaud ◽

Ines Zapiola ◽

Silvina Fernandez Giuliano ◽

Rosa Bologna ◽

...

Keyword(s):

Drug Resistance ◽

Current Knowledge ◽

Phylogenetic Analyses ◽

Genotypic Diversity ◽

Resistance Testing ◽

Cross Resistance ◽

Resistance Mutations ◽

Middle Income ◽

Subtype B ◽

Hiv 1

Abstract Background Current knowledge on HIV-1 resistance to integrase inhibitors (INIs) is based mostly on subtype B strains. This contrasts with the increasing use of INIs in low- and middle-income countries, where non-B subtypes predominate. Materials and methods HIV-1 drug resistance genotyping was performed in 30 HIV-1-infected individuals undergoing virological failure to raltegravir. Drug resistance mutations (DRMs) and HIV-1 subtype were characterized using Stanford HIVdb and phylogenetic analyses. Results Of the 30 integrase (IN) sequences, 14 were characterized as subtype F (47%), 8 as subtype B (27%), 7 as BF recombinants (23%) and 1 as a putative CRF05_DF (3%). In 25 cases (83%), protease and reverse transcriptase (PR-RT) sequences from the same individuals confirmed the presence of different BF recombinants. Stanford HIVdb genotyping was concordant with phylogenetic inference in 70% of IN and 60% of PR-RT sequences. INI DRMs differed between B and F IN subtypes, with Q148K/R/H, G140S and E138K/A being more prevalent in subtype B (63% versus 0%, P = 0.0021; 50% versus 0%, P = 0.0096; and 50% versus 0%, P = 0.0096, respectively). These differences were independent of the time on raltegravir therapy or viral load at the time of genotyping. INI DRMs in subtype F IN genomes predicted a lower level of resistance to raltegravir and no cross-resistance to second-generation INIs. Conclusions Alternative resistance pathways to raltegravir develop in subtypes B and F IN genomes, with implications for clinical practice. Evaluating the role of HIV-1 subtype in development and persistence of mutations that confer resistance to INIs will be important to improve algorithms for resistance testing and optimize the use of INIs.

Download Full-text

Risk Factors Associated with Sexually Transmitted Infections among Pre-Exposure Prophylaxis Users in an Urban Multi-Clinic Healthcare System

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1785 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S668-S669 ◽

Cited By ~ 1

Author(s):

Alexandra Abrams-Downey ◽

Ana Ventuneac ◽

Bianca Duah ◽

Joaquin Aracena ◽

Hansel Arroyo ◽

...

Keyword(s):

Risk Factors ◽

Sexually Transmitted Infections ◽

Healthcare System ◽

Sexually Transmitted ◽

Factors Associated ◽

Exposure Prophylaxis

Download Full-text

Lymphogranuloma venereum (LGV) in men who have sex with men (MSM): a re-emerging problem, Malta, 2018

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.43.1800541 ◽

2018 ◽

Vol 23 (43) ◽

Author(s):

Alastair Donachie ◽

Gianfranco Spiteri ◽

Christopher Barbara ◽

Tanya Melillo ◽

Ronza Hadad ◽

...

Keyword(s):

Risk Factors ◽

Lymphogranuloma Venereum ◽

Factors Associated ◽

Sex Parties ◽

Sex With Men ◽

Group Sex

From 1 January to 30 June 2018, 11 cases of Lymphogranuloma venereum (LGV; all preserved samples (n = 4) genovar L2b) were identified at the Genitourinary Clinic (GUC), Mater Dei Hospital, Msida, Malta. All cases were diagnosed in men who have sex with men (MSM); six participated in three group-sex parties. Here, we describe the outbreak and risk factors associated with LGV diagnoses in MSM in Malta in 2018.

Download Full-text

HIV: introduction and epidemiology

Oxford Handbook of Genitourinary Medicine, HIV, and Sexual Health ◽

10.1093/med/9780198783497.003.0037 ◽

2019 ◽

pp. 449-456

Keyword(s):

Risk Factors ◽

Immune Deficiency ◽

Immune Deficiency Syndrome ◽

Acquired Immune Deficiency Syndrome ◽

Deficiency Syndrome ◽

Background Information ◽

Prevalence Data ◽

Sex With Men ◽

Acquired Immune Deficiency ◽

Hiv 1

This chapter provides background information to the events that led to the discovery of HIV. Previously fit young men who have sex with men presented with certain infections and cancers, coupled with severe immune deficiency, which was later given the name acquired immune deficiency syndrome (AIDS). This chapter gives information about the origin of HIV and its link to simian immunodeficiency viruses (SIVs). This chapter provides information on the geographical, and the epidemiological differences between HIV-1 and HIV-2. The chapter also explains the biological implications of HIV types and subtypes. Risk factors and transmission routes are also discussed, in addition to UK and worldwide HIV prevalence data.

Download Full-text

Evaluation of HIV Transmission Clusters among Natives and Foreigners Living in Italy

Viruses ◽

10.3390/v12080791 ◽

2020 ◽

Vol 12 (8) ◽

pp. 791 ◽

Cited By ~ 2

Author(s):

Lavinia Fabeni ◽

Maria Mercedes Santoro ◽

Patrizia Lorenzini ◽

Stefano Rusconi ◽

Nicola Gianotti ◽

...

Keyword(s):

Hiv Transmission ◽

Phylogenetic Analyses ◽

Hiv Infections ◽

Public Health Response ◽

Health Response ◽

Drug Naïve ◽

Recent Diagnosis ◽

Sex With Men ◽

Italian Origin ◽

Hiv 1

We aimed at evaluating the characteristics of HIV-1 molecular transmission clusters (MTCs) among natives and migrants living in Italy, diagnosed between 1998 and 2018. Phylogenetic analyses were performed on HIV-1 polymerase (pol) sequences to characterise subtypes and identify MTCs, divided into small (SMTCs, 2–3 sequences), medium (MMTCs, 4–9 sequences) and large (LMTCs, ≥10 sequences). Among 3499 drug-naïve individuals enrolled in the Italian Cohort Naive Antiretroviral (ICONA) cohort (2804 natives; 695 migrants), 726 (20.8%; 644 natives, 82 migrants) were involved in 228 MTCs (6 LMTCs, 36 MMTCs, 186 SMTCs). Migrants contributed 14.4% to SMTCs, 7.6% to MMTCs and 7.1% to LMTCs, respectively. HIV-1 non-B subtypes were found in 51 MTCs; noteworthy was that non-B infections involved in MTCs were more commonly found in natives (n = 47) than in migrants (n = 4). Factors such as Italian origin, being men who have sex with men (MSM), younger age, more recent diagnosis and a higher CD4 count were significantly associated with MTCs. Our findings show that HIV-1 clustering transmission among newly diagnosed individuals living in Italy is prevalently driven by natives, mainly MSM, with a more recent diagnosis and frequently infected with HIV-1 non-B subtypes. These results can contribute to monitoring of the HIV epidemic and guiding the public health response to prevent new HIV infections.

Download Full-text