Impact of highly active antiretroviral therapy on the molecular epidemiology of newly diagnosed HIV infections

被引：40

作者：

Ambrosioni, Juan ^{[1
,2
]}

Junier, Thomas ^{[3
,4
]}

Delhumeau, Cecile ^{[2
]}

Calmy, Alexandra ^{[2
]}

Hirschel, Bernard ^{[2
]}

Zdobnov, Evgeny ^{[3
,4
]}

Kaiser, Laurent ^{[1
]}

Yerly, Sabine ^{[1
]}

机构：

[1] Univ Hosp, Virol Lab, Dept Genet & Lab Med, Geneva, Switzerland

[2] Univ Hosp, Div Infect Dis, HIV Unit, Dept Med Special, Geneva, Switzerland

[3] Univ Hosp Geneva, Computat Evolutionary Genom Grp, CH-1211 Geneva 14, Switzerland

[4] Univ Geneva, Sch Med, CH-1211 Geneva, Switzerland

来源：

AIDS | 2012年 / 26卷 / 16期

基金：

瑞士国家科学基金会;

关键词：

HIV transmission; MSM; molecular epidemiology highly active antiretroviral therapy; prevention; recent infection; resistance; DRUG-RESISTANCE; TRANSMISSION CLUSTERS; SUBTYPE B; INTERRUPTION; PREVENTION; MUTATIONS;

D O I：

10.1097/QAD.0b013e32835805b6

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: To evaluate HIV-1 transmission trends and the impact of highly active anti-retroviral 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. (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

引用

页码：2079 / 2086

页数：8

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