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Impact of highly active antiretroviral therapy on the molecular epidemiology of newly diagnosed HIV infections.
MedLine Citation:
PMID:  23052354     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: To evaluate HIV-1 transmission trends and the impact of highly active antiretroviral therapy (HAART) on newly diagnosed HIV infections in Geneva, Switzerland. DESIGN:: Retrospective molecular epidemiology analysis of all newly HIV-diagnosed individuals between 2008 and 2010. METHODS:: Phylogenetic analyses were performed using pol sequences of 780 newly HIV-1 diagnosed individuals between 2000 and 2010 (mandatory reporting) and 1058 individuals diagnosed before 2000. All clusters (bootstrap value >98%) including individuals diagnosed in 2008-2010 were analyzed. Recent HIV infections (<1 year) were determined by documented seroconversion and/or fraction of ambiguous nucleotides. Median viral load and HAART coverage during the study period were obtained from patients included in the Swiss HIV Cohort Study (SHCS). RESULTS:: Among 142 newly diagnosed individuals during 2008-2010, 49% had a recent infection and 42% were included in transmission clusters. Among the latter, two-thirds were included in new clusters and one-third expanded previously known clusters. MSM carrying resistant strains were more frequently included in clusters. Only 1.8% of individuals diagnosed before 2000 and 10.8% diagnosed during 2000-2008 were included in clusters involving individuals diagnosed between 2008 and 2010. During 2008-2010, the median population viral load of SHCS-enrolled individuals was significantly lower for individuals diagnosed before 2000 than for those diagnosed during 2000-2008 and 2008-2010 and HAART coverage significantly higher. CONCLUSIONS:: MSM with recent HIV infection are a significant source of onward transmission. Individuals diagnosed before 2000 were only exceptionally related to newly diagnosed infections between 2008 and 2010. Prevention campaigns need to be focused on improving diagnosis for recently infected individuals.
Authors:
Juan Ambrosioni; Thomas Junier; Cécile Delhumeau; Alexandra Calmy; Bernard Hirschel; Evgeny Zdobnov; Laurent Kaiser; Sabine Yerly;
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  AIDS (London, England)     Volume:  26     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  -    
Other Details:
Languages:  ENG     Pagination:  2079-2086     Citation Subset:  -    
Affiliation:
aLaboratory of Virology, Department of Genetics and Laboratory Medicine, University Hospital bHIV Unit, Division of Infectious Diseases, Department of Medical Specialities, University Hospital cComputational Evolutionary Genomics Group, University of Geneva Hospitals and School of Medicine, Geneva, Switzerland.
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