HIV transmission among acutely infected participants of a Dutch cohort study 2015-2021 is not associated with large, clustered outbreaks.

Autor:	Prins HAB; Department of Medical Microbiology and Infectious Diseases and Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands., Rokx C; Department of Medical Microbiology and Infectious Diseases and Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands., Verbon A; Department of Medical Microbiology and Infectious Diseases and Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands., van Sighem A; Stichting HIV Monitoring (SHM), Amsterdam, The Netherlands., de Bree GJ; Department of Internal Medicine, Division of Infectious Diseases, and Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam., Dijkstra M; Department of Internal Medicine, Division of Infectious Diseases, and Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam.; Department of Infectious Diseases, Public Health Service of Amsterdam., Prins JM; Department of Internal Medicine, Division of Infectious Diseases, and Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam., Reiss P; Stichting HIV Monitoring (SHM), Amsterdam, The Netherlands.; Department of Internal Medicine, Division of Infectious Diseases, and Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam.; Department of Global Health, Amsterdam UMC, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam., van Kampen JJA; Department of Viroscience, Erasmus University Medical Centre, Rotterdam, the Netherlands., van de Vijver DAMC; Department of Viroscience, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	AIDS (London, England) [AIDS] 2023 Feb 01; Vol. 37 (2), pp. 299-303. Date of Electronic Publication: 2022 Nov 18.
DOI:	10.1097/QAD.0000000000003416
Abstrakt:	Objective: Timely identification of acute or early HIV infection (AEHI) is important to help prevent onward transmission, and understanding the number of secondary infections resulting from individuals with AEHI is key to planning HIV prevention services and case finding. Design: We performed a phylogenetic investigation of a dense sample of individuals with AEHI who took part in the Netherlands Cohort Study on Acute HIV infection (NOVA) in the Netherlands during 2015-2021. Methods: Transmission clusters were identified using phylogenetic analyses based on HIV pol sequences. The Tamura-Nei model was used to estimate genetic distance. A number of 1000 bootstraps was used to check the reliability of clustering using maximum likelihood. A cluster was defined as having a bootstrap value of at least 95% and a genetic distance of at most 1.5%. Sensitivity analyses using different values for the bootstrap and genetic distance were performed to study the reproducibility of the clustering. Results: Of the 156 participants included in NOVA between July 2015 and April 2021, 134 individuals for whom baseline characteristics and genotypic resistance data at baseline were available could be included. We identified 10 clusters, but the majority of persons (111/134) were not part of a cluster, suggesting mainly independent transmission events. Conclusion: Mainly independent transmission events among a study population consisting predominantly of MSM in a low-incidence high-resource setting is likely the result of active AEHI case finding and direct start of treatment, and the roll-out over recent years of preventive measures such as preexposure prophylaxis. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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