HIV-1 Transmission During Recent Infection and During Treatment Interruptions as Major Drivers of New Infections in the Swiss HIV Cohort Study.

Détails

ID Serval
serval:BIB_BB1D1B3BB7A2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
HIV-1 Transmission During Recent Infection and During Treatment Interruptions as Major Drivers of New Infections in the Swiss HIV Cohort Study.
Périodique
Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America
Auteur(s)
Marzel A., Shilaih M., Yang W.L., Böni J., Yerly S., Klimkait T., Aubert V., Braun D.L., Calmy A., Furrer H., Cavassini M., Battegay M., Vernazza P.L., Bernasconi E., Günthard H.F., Kouyos R.D.
Collaborateur(s)
Swiss HIV Cohort Study
Contributeur(s)
Aubert V., Battegay M., Bernasconi E., Böni J., Bucher HC., Burton-Jeangros C., Calmy A., Cavassini M., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux CA., Gorgievski M., Günthard HF., Haerry D., Hasse B., Hirsch HH., Hoffmann M., Hösli I., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kouyos RD., Kovari H., Ledergerber B., Martinetti G., Martinez de Tejada B., Metzner K., Müller N., Nadal D., Nicca D., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schöni-Affolter F., Schmid P., Schüpbach J., Speck R., Tarr P., Trkola A., Vernazza PL., Weber R., Yerly S.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
62
Numéro
1
Pages
115-122
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
BACKGROUND: Reducing the fraction of transmissions during recent human immunodeficiency virus (HIV) infection is essential for the population-level success of "treatment as prevention".
METHODS: A phylogenetic tree was constructed with 19 604 Swiss sequences and 90 994 non-Swiss background sequences. Swiss transmission pairs were identified using 104 combinations of genetic distance (1%-2.5%) and bootstrap (50%-100%) thresholds, to examine the effect of those criteria. Monophyletic pairs were classified as recent or chronic transmission based on the time interval between estimated seroconversion dates. Logistic regression with adjustment for clinical and demographic characteristics was used to identify risk factors associated with transmission during recent or chronic infection.
FINDINGS: Seroconversion dates were estimated for 4079 patients on the phylogeny, and comprised between 71 (distance, 1%; bootstrap, 100%) to 378 transmission pairs (distance, 2.5%; bootstrap, 50%). We found that 43.7% (range, 41%-56%) of the transmissions occurred during the first year of infection. Stricter phylogenetic definition of transmission pairs was associated with higher recent-phase transmission fraction. Chronic-phase viral load area under the curve (adjusted odds ratio, 3; 95% confidence interval, 1.64-5.48) and time to antiretroviral therapy (ART) start (adjusted odds ratio 1.4/y; 1.11-1.77) were associated with chronic-phase transmission as opposed to recent transmission. Importantly, at least 14% of the chronic-phase transmission events occurred after the transmitter had interrupted ART.
CONCLUSIONS: We demonstrate a high fraction of transmission during recent HIV infection but also chronic transmissions after interruption of ART in Switzerland. Both represent key issues for treatment as prevention and underline the importance of early diagnosis and of early and continuous treatment.
Mots-clé
Adult, Algorithms, Cluster Analysis, Cohort Studies, Female, HIV Infections/drug therapy, HIV Infections/epidemiology, HIV-1/genetics, Humans, Male, Phylogeny, Risk Factors, Switzerland/epidemiology
Pubmed
Web of science
Open Access
Oui
Création de la notice
08/01/2016 11:17
Dernière modification de la notice
20/08/2019 16:29
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