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

Viruses ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 791 ◽  
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.

Characterisation of HIV-1 molecular transmission clusters among newly diagnosed individuals infected with non-B subtypes in Italy

2019 ◽  
Vol 95 (8) ◽  
pp. 619-625 ◽  
Author(s):  
Lavinia Fabeni ◽  
Claudia Alteri ◽  
Giulia Berno ◽  
Rossana Scutari ◽  
Nicoletta Orchi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cell Count ◽  
Phylogenetic Analyses ◽  
Newly Diagnosed ◽  
Public Health Response ◽  
Cd4 Cell Count ◽  
Sex With Men ◽  
Italian Origin ◽  
Cd4 Cell ◽  
Hiv 1

ObjectiveWe evaluated the characteristics of HIV-1 molecular transmission clusters (MTCs) in 1890 newly diagnosed individuals infected with non-B subtypes between 2005 and 2017 in Italy.MethodsPhylogenetic analyses were performed on pol sequences to characterise subtypes/circulating recombinant forms and identify MTCs. MTCs were divided into small (SMTCs, 2–3 sequences), medium (MMTCs, 4–9 sequences) and large (LMTCs, ≥10 sequences). Factors associated with MTCs were evaluated using logistic regression analysis.Results145 MTCs were identified and involved 666 individuals (35.2%); 319 of them (16.9%) were included in 13 LMTCs, 111 (5.9%) in 20 MMTCs and 236 (12.5%) in 112 SMTCs. Compared with individuals out of MTCs, individuals involved in MTCs were prevalently Italian (72.7% vs 30.9%, p<0.001), male (82.9% vs 62.3%, p<0.001) and men who have sex with men (MSM) (43.5% vs 14.5%, p<0.001). Individuals in MTCs were also younger (median (IQR) years: 41 (35–49) vs 43 (36–51), p<0.001) and had higher CD4 cell count in comparison with individuals out of MTCs (median (IQR): 109/L: 0.4 (0.265–0.587) vs 0.246 (0.082–0.417), p<0.001). The viral load remained stable between the two groups (median (IQR) log10 copies/mL: 4.8 (4.2–5.5) vs 5.0 (4.3–5.5), p=0.87). Logistic regression confirmed that certain factors such as being MSM, of Italian origin, younger age and higher CD4 cell count were significantly associated with MTCs.ConclusionsOur findings show that HIV-1 newly diagnosed individuals infected with non-B subtypes are involved in several MTCs in Italy. These MTCs include mainly Italians and MSM and highlight the complex phenomenon characterising the HIV-1 spread. This is important especially in view of monitoring the HIV epidemic and guiding the public health response.

scholarly journals Phylogenetic evidence of HIV-1 transmission linkage between two men who have sex with men

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jiafeng Zhang ◽  
Qin Fan ◽  
Mingyu Luo ◽  
Jiaming Yao ◽  
Xiaohong Pan ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Phylogenetic Analyses ◽  
Recent Common Ancestor ◽  
Hiv Positive ◽  
Most Recent Common Ancestor ◽  
Hiv Seroconversion ◽  
Selective Forces ◽  
Sex With Men ◽  
Hiv 1 ◽  
Control Sequences

Abstract Background In China, an HIV-infected man (complainant; P2) alleged that another man (defendant; P1) had unlawfully infected him with HIV through unprotected homosexual contact in 2018. Methods We employed epidemiological, serological and phylogenetic analyses to investigate the transmission linkage between two men who have sex with men (MSM). Partial segments of three HIV-1 gene regions (gag, pol, and env) were amplified and sequenced by cloning. Maximum-likelihood (ML) and Bayesian methods were used to determine the direction and estimate the timing of transmission. Local control sequences and database control sequences were also used in the phylogenetic analysis. Results It indicated that P2 underwent HIV seroconversion after P1 was diagnosed as HIV positive. The time to the most recent common ancestor (tMRCA) estimates consistently showed that P1 most likely became HIV-1 infected at an earlier date than P2. P1 and P2 were infected with the same HIV-1 CRF01_AE subtype according to segments of all three gene regions (gag, pol, and env). All three genetic regions of P1 have been subject to more potential selective forces than those of P2, indicating a longer evolutionary history. Bayesian and ML trees showed similar paraphyletic-monophyletic topologies of gag and env, with the virus from P1 located at the root, which supported a P1-to-P2 transmission direction. Conclusions Phylogenetic investigations can elucidate HIV transmission linkage and might empower its use in the opposition of the intentional transmission of HIV-1 as a forensic tool.

Superimposing incident sexually transmitted infections on HIV phylogram to investigate possible misclassification of men who have sex with men as heterosexuals in a cohort in Antwerp, Belgium

2019 ◽  
Vol 30 (5) ◽  
pp. 486-495
Author(s):  
Kara K Osbak ◽  
Conor J Meehan ◽  
Sergio G Ribas ◽  
Leo Heyndrickx ◽  
Kevin K Ariën ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexual Behaviour ◽  
Hiv Transmission ◽  
Phylogenetic Analyses ◽  
Laboratory Data ◽  
Risk Groups ◽  
Transmission Risk ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Hiv Transmission Risk

In this study, we assessed if the superimposition of incident sexually transmitted infections (STIs) on HIV phylogenetic analyses could reveal possible sexual behaviour misclassifications in our HIV-infected population. HIV-1 sequences collected between 1997 and 2014 from 1169 individuals attending a HIV clinic in Antwerp, Belgium were analysed to infer a partial HIV transmission network. Individual demographic, clinical and laboratory data collected during routine HIV follow-up were used to compare clustered and non-clustered individuals using logistic regression analyses. In total, 438 (37.5%) individuals were identified in 136 clusters, including 76 transmission pairs and 60 clusters consisting of three or more individuals. Individuals in a cluster were more likely to have a history of syphilis, Chlamydia and/or gonorrhoea (P < 0.05); however, when analyses were stratified by HIV transmission risk groups (heterosexual and men who have sex with men [MSM]), this association only remained significant for heterosexuals with syphilis (P = 0.001). Under closer scrutiny, this association was driven by six heterosexual men who were located in six almost exclusively MSM clusters. A parsimonious conclusion is that these six individuals were potentially misclassified as heterosexual. Improving the accuracy of sexual behaviour reporting could improve care.

scholarly journals Herpes simplex virus 2 serostatus and viral loads of HIV-1 in blood and semen as risk factors for HIV transmission among men who have sex with men

AIDS ◽  
2008 ◽  
Vol 22 (13) ◽  
pp. 1667-1671 ◽  
Author(s):  
David M Butler ◽  
Davey M Smith ◽  
Edward R Cachay ◽  
George K Hightower ◽  
Charles Thomas Nugent ◽  
...  
Keyword(s):  
Risk Factors ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Hiv Transmission ◽  
Viral Loads ◽  
Sex With Men ◽  
Simplex Virus ◽  
Herpes Simplex Virus 2 ◽  
Hiv 1

scholarly journals Antiretroviral therapy for prevention of HIV transmission: implications for Europe

2013 ◽  
Vol 18 (48) ◽  
Author(s):  
V Cambiano ◽  
J O’Connor ◽  
A N Phillips ◽  
A Rodger ◽  
R Lodwick ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Who Inject Drugs ◽  
Hiv Transmission ◽  
Controlled Trial ◽  
Population Level ◽  
Hiv Infections ◽  
Cd4 Count ◽  
Art Initiation ◽  
Sex With Men ◽  
Randomised Controlled

The aim of this review is to summarise the evidence on the population-level effect of antiretroviral therapy (ART) in preventing HIV infections, and to discuss potential implications in the European context of recommending starting ART when the CD4 count is above 350 cells/mm3. The ability of ART to reduce the risk of HIV transmission has been reported in observational studies and in a randomised controlled trial (HPTN 052), in which ART initiation reduced HIV transmission by 96% within serodiscordant couples. As yet, there is no direct evidence for such an effect among men having sex with men or people who inject drugs. HPTN 052 led international organisations to develop recommendations with a higher CD4 threshold for ART initiation. However, there remains a lack of strong evidence of clinical benefit for HIV-positive individuals starting ART with CD4 count above 350 cells/mm3. The main goal of ART provision should be to increase ART coverage for all those in need, based on the current guidelines, and the offer of ART to those who wish to reduce infectivity; increased HIV testing is therefore a key requirement. Other proven prevention means such as condom use and harm reduction for people who inject drugs remain critical.

scholarly journals Overview of genotypic and clinical profiles of human immunodeficiency virus type 1-infected children in Rio de Janeiro, Brazil

2004 ◽  
Vol 76 (4) ◽  
pp. 727-741 ◽  
Author(s):  
Elizabeth S. Machado ◽  
John S. Lambert ◽  
Adriana O. Afonso ◽  
Silvia M. Cunha ◽  
Ricardo H. Oliveira ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Rio De Janeiro ◽  
Hiv Transmission ◽  
Clinical Laboratory ◽  
Adult Population ◽  
Developed Countries ◽  
Pediatric Hiv ◽  
Resistance Mutations ◽  
Drug Naïve ◽  
Hiv 1

Although mother-to-child HIV transmission prevention has slowed down pediatric HIV infection in developed countries, large numbers of infants still become infected in developing nations. Data on pediatric HIV infection is however largely scarce. In this study, we have overviewed clinical, laboratory and genotypic data from a large cohort of HIV-infected infants regularly followed at two pediatric HIV outpatient clinics in Rio de Janeiro, Brazil. Children on antiretroviral therapy, as well as drug-naïve, newly diagnosed infants were analyzed. Prevalence of drug resistance mutations, as well as immunological and virological responses to therapy were evaluated. Additionally, HIV-1 subtype frequencies and their distribution over the course of the epidemic were studied. We have found a high prevalence of mutations among ARV-experienced children, whereas mutations were absent in the drug-naïve group. Despite the high levels of resistance among treated infants, an important improvement of their immunological status was observed. HIV-1 subtype distribution followed the trends of the adult population, with the appearance of non-B subtypes and recombinant forms after 1990. To our knowledge, this is the largest pediatric cohort ever analyzed in Brazil, and the data provided is of paramount importance to a better understanding of HIV/AIDS evolution in pediatric settings.

scholarly journals HIV-1 Infection and Transmission Networks of Younger People in Chicago, Illinois, 2005-2011

2016 ◽  
Vol 132 (1) ◽  
pp. 48-55 ◽  
Author(s):  
Ethan Morgan ◽  
Alexandra M. Oster ◽  
Stephanie Townsell ◽  
Donna Peace ◽  
Nanette Benbow ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Black People ◽  
Multivariable Analysis ◽  
Transmission Networks ◽  
Metropolitan Regions ◽  
Infected People ◽  
Sex With Men ◽  
High Level ◽  
High Degree ◽  
Hiv 1

Objective: Analysis of HIV nucleotide sequences can be used to identify people with highly similar HIV strains and understand transmission patterns. The objective of this study was to identify groups of people highly connected by HIV transmission and the extent to which transmission occurred within and between geographic areas in Chicago, Illinois. Methods: We analyzed genetic sequences in the HIV-1 pol region in samples collected from people participating in the VARHS program in Chicago during 2005-2011. We determined pairwise genetic distance, inferred potential transmission events between HIV-infected people whose sequences were ≤1.5% genetically distant, and identified clusters of connected people. We used multivariable analysis to determine demographic characteristics and risk attributes associated with degree of connectivity. Results: Of 1154 sequences, 177 (15.3%) were tied to at least 1 other sequence. We determined that younger people, men, non-Hispanic black people, and men who have sex with men were more highly connected than other HIV-infected people. We also identified a high degree of geographic heterogeneity—48 of 67 clusters (71.6%) contained people from >1 Chicago region (north, south, or west sides). Conclusion: Our results indicate a need to address HIV transmission through the networks of younger non-Hispanic black men who have sex with men. The high level of geographic heterogeneity observed suggests that HIV prevention programs should be targeted toward networks of younger people rather than geographic areas of high incidence. This study could also guide prevention efforts in other diverse metropolitan regions with characteristics similar to those of Chicago.

scholarly journals HIV incidence among gay men and other men who have sex with men in 2020: where is the epidemic heading?

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 5 ◽  
Author(s):  
Shauna Stahlman ◽  
Carrie Lyons ◽  
Patrick S. Sullivan ◽  
Kenneth H. Mayer ◽  
Sean Hosein ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
Retention In Care ◽  
Hiv Treatment ◽  
Treatment As Prevention ◽  
Structural Level ◽  
Hiv Incidence ◽  
Hiv Risks ◽  
Sex With Men ◽  
Hiv Acquisition

The goal to effectively prevent new HIV infections among gay, bisexual, and other men who have sex with men (MSM) is more challenging now than ever before. Despite declines in the late 1990s and early 2000s, HIV incidence among MSM is now increasing in many low- and high-income settings including the US, with young, adolescent, and racial/ethnic minority MSM being among those at highest risk. Potentiating HIV risks across all settings are individual-, network-, and structural-level factors such as stigma and lack of access to pre-exposure prophylaxis (PrEP) and antiretroviral treatment as prevention. To make a sustained impact on the epidemic, a concerted effort must integrate all evidence-based interventions that will most proximally decrease HIV acquisition and transmission risks, together with structural interventions that will support improved coverage and retention in care. Universal HIV treatment, increased access to HIV testing, and daily oral PrEP have emerged as integral to the prevention of HIV transmission, and such efforts should be immediately expanded for MSM and other populations disproportionately affected by HIV. Respect for human rights and efforts to combat stigma and improve access to prevention services are needed to change the trajectory of the HIV pandemic among MSM.

scholarly journals Demographic characteristics and spatial clusters of recent HIV-1 infections among newly diagnosed HIV-1 cases in Yunnan, China, 2015

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Min Chen ◽  
Yanling Ma ◽  
Huichao Chen ◽  
Jie Dai ◽  
Hongbing Luo ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
Demographic Characteristics ◽  
Scan Statistics ◽  
Newly Diagnosed ◽  
Spatial Clusters ◽  
Hiv Surveillance ◽  
Pregnancy And Childbirth ◽  
Hiv 1 ◽  
Hiv Aids

Abstract Background The characteristics of recent HIV infections can provide the information about the dynamics of HIV transmission. Yunnan is one of the provinces hardest-hit by HIV-1 in China. To further understand the characteristics of the HIV-1 epidemic in Yunnan, we analyzed the prevalence of recent HIV-1 infections among newly diagnosed cases, identified the associated factors and explored the spatial distribution of recent HIV-1 infections. Methods Residual plasma samples from HIV-1 diagnostic tests were preserved. The associated information was collected from China HIV/AIDS case reporting system. Recent HIV-1 infections were estimated by combining the information about disease progression and BED- capture enzyme immunoassay (CEIA). The proportions of recent HIV-1 infections among newly diagnosed cases stratified by demographic characteristics were analyzed. The spatial clusters of recent HIV-1 infections were investigated by spatial scan statistics. Results Among 6119 HIV/AIDS cases were newly reported between January 2015 and June 2015 in Yunnan Province, 9.3% (570/6119) were estimated as recent infections. Female, aged below 25 years and homosexual contact were more associated with the higher proportion of recent HIV-1 infections. Among the different demographic sub-groups, men who have sex with men (MSM) aged < 25 years and ≥ 50 years had a higher chance of being diagnosed as recent infections, heterosexually infected men aged ≥25 years had a lower chance of being diagnosed as recent infections. In the sub-groups with different screening approaches, the highest proportion of recent infections (16.1%) was found among women diagnosed by testing during pregnancy and childbirth. In the sub-groups with different contact histories, the higher proportion of recent infections was found among the female cases having commercial heterosexual contacts (16.4%) and MSM (19.7%). The statistically significant spatial clusters of recent infections attributed to heterosexual contact, homosexual contact and intravenous drug injection were identified, respectively. Conclusions The investigation of recent HIV infections among newly diagnosed cases supplements the routine HIV surveillance, and reveals the characteristics of ongoing HIV transmission. Our finding identified the potential sub-populations and geographic areas in need of services or improved interventions.

Genetic transmission networks reveal the transmission patterns of HIV-1 CRF01_AE in China

2017 ◽  
Vol 94 (2) ◽  
pp. 111-116 ◽  
Author(s):  
Xiaoshan Li ◽  
Rong Gao ◽  
Kexin Zhu ◽  
Feiran Wei ◽  
Kun Fang ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Risk Groups ◽  
Public Health Issue ◽  
Transmission Networks ◽  
Major Public Health Issue ◽  
Genetic Transmission ◽  
Heterosexual Women ◽  
Sex With Men ◽  
Migrant People ◽  
Hiv 1

ObjectivesThe epidemic of HIV-1 CRF01_AE has become a major public health issue in China. This study aimed to characterise the transmission patterns of genetic networks for CRF01_AE nationwide and elucidate possible opportunities for prevention.MethodsWe isolated and conducted genetic transmission network analysis of all available CRF01_AE pol sequences (n=4704) from China in the Los Alamos HIV sequence database.ResultsA total of 1391 (29.6%) sequences were identified as belonging to 400 separate networks. Of men who have sex with men (MSM) in the networks, 93.8% were linked to other MSM and only 2.4% were linked to heterosexual women. However, 11.8% heterosexual women in the networks were linked to MSM. Lineages composed mainly of MSM had higher transmission than those that were mostly heterosexuals. Of the 1391 individuals in networks, 513 (36.9%) were linked to cases diagnosed in different provinces. The proportion of individuals involved in inter-province links was interrelated with the number of migrant people (Spearman’s r=0.738, p=0.001).ConclusionsThe outcome of this study could help improve our ability to understand HIV transmission among various regions and risk groups in China, and highlighted the importance of targeting MSM and migrants by prevention and intervention efforts.

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