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Wang Z, Wang D, Lin L, Qiu Y, Zhang C, Xie M, Lu X, Lian Q, Yan P, Chen L, Feng Y, Xing H, Wang W, Wu S. Epidemiological characteristics of HIV transmission in southeastern China from 2015 to 2020 based on HIV molecular network. Front Public Health 2023; 11:1225883. [PMID: 37942240 PMCID: PMC10629674 DOI: 10.3389/fpubh.2023.1225883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
Objective HIV/AIDS remains a global public health problem, and understanding the structure of social networks of people living with HIV/AIDS is of great importance to unravel HIV transmission, propose precision control and reduce new infections. This study aimed to investigate the epidemiological characteristics of HIV transmission in Fujian province, southeastern China from 2015 to 2020 based on HIV molecular network. Methods Newly diagnosed, treatment-naive HIV/AIDS patients were randomly sampled from Fujian province in 2015 and 2020. Plasma was sampled for in-house genotyping resistance test, and HIV molecular network was created using the HIV-TRACE tool. Factors affecting the inclusion of variables in the HIV molecular network were identified using univariate and multivariate logistic regression analyses. Results A total of 1,714 eligible cases were finally recruited, including 806 cases in 2015 and 908 cases in 2020. The dominant HIV subtypes were CRF01_AE (41.7%) and CRF07_BC (38.3%) in 2015 and CRF07_BC (53. 3%) and CRF01_AE (29.1%) in 2020, and the prevalence of HIV drug resistance was 4.2% in 2015 and 5.3% in 2020. Sequences of CRF07_BC formed the largest HIV-1 transmission cluster at a genetic distance threshold of both 1.5 and 0.5%. Univariate and multivariate logistic regression analyses showed that ages of under 20 years and over 60 years, CRF07_BC subtype, Han ethnicity, sampling in 2015, absence of HIV drug resistance, married with spouse, sampling from three cities of Jinjiang, Nanping and Quanzhou resulted in higher proportions of sequences included in the HIV transmission molecular network at a genetic distance threshold of 1.5% (p < 0.05). Conclusion Our findings unravel the HIV molecular transmission network of newly diagnosed HIV/AIDS patients in Fujian province, southeastern China, which facilitates the understanding of HIV transmission patterns in the province.
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Affiliation(s)
- Zhenghua Wang
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Dong Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liying Lin
- Fuzhou Institute for Disease Control and Prevention of China Railway Nanchang Bureau Group Co., Ltd., Fuzhou, China
| | - Yuefeng Qiu
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Chunyan Zhang
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Meirong Xie
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Xiaoli Lu
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Qiaolin Lian
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Pingping Yan
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Liang Chen
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Yi Feng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Xing
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Wang
- National Health Commission Key Laboratory for Parasitic Disease Prevention and Control, Jiangsu Provincial Key Laboratory for Parasites and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Shouli Wu
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
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Mbuagbaw L, Garcia C, Brenner B, Cecchini D, Chakroun M, Djiadeu P, Holguin A, Mor O, Parkin N, Santoro MM, Ávila-Ríos S, Fokam J, Phillips A, Shafer RW, Jordan MR. Checklist for studies of HIV drug resistance prevalence or incidence: rationale and recommended use. Lancet HIV 2023; 10:e684-e689. [PMID: 37716367 PMCID: PMC11060097 DOI: 10.1016/s2352-3018(23)00173-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/24/2023] [Accepted: 07/05/2023] [Indexed: 09/18/2023]
Abstract
HIV drug resistance (HIVDR) is a major challenge to the effectiveness of antiretroviral therapy. Global efforts in addressing HIVDR require clear, transparent, and replicable reporting in HIVDR studies. We describe the rationale and recommended use of a checklist that should be included in reports of HIVDR incidence and prevalence. After preliminary consultations with experts on HIVDR and establishing the need for guidance on HIVDR reporting, we used a sequential, explanatory, mixed methods approach to create the checklist; together with the accompanying articles, the checklist was reviewed by the authors and validated externally. The checklist for studies on HIVDR prevalence or incidence (CEDRIC-HIV) includes 15 recommended items that would enhance transparency and facilitate interpretation, comparability, and replicability of HIVDR studies. CEDRIC-HIV will help authors of HIVDR studies prepare research reports and assist reviewers and editors in assessments of completeness of reporting. The checklist will also facilitate statistical pooling and interpretation of HIVDR data.
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Affiliation(s)
- Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Anesthesia, McMaster University, Hamilton, ON, Canada; Department of Pediatrics, McMaster University, Hamilton, ON, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada; Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon; Department of Global Health, Stellenbosch University, Cape Town, South Africa.
| | - Cristian Garcia
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Bluma Brenner
- McGill Centre for Viral Diseases, Lady Davis Institute for Medical Research, Montréal, QC, Canada; Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada; Department of Medicine, Surgery, and Infectious Disease, McGill University, Montréal, QC, Canada
| | - Diego Cecchini
- Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina; Helios Salud, Buenos Aires, Argentina
| | - Mohamed Chakroun
- Infectious Diseases Department, Fatouma Bourguiba University Hospital, Monastir, Tunisia
| | - Pascal Djiadeu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Yale University School of Nursing, Yale University, West Haven, CT, USA; Centre for Urban Health Solutions, St Michael's Hospital, Toronto, ON, Canada
| | - Africa Holguin
- HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Ramón y Cajal-IRYCIS and CIBEREsp-RITIP, Madrid, Spain
| | - Orna Mor
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Central Virology Laboratory, Ministry of Health and Sheba Medical Centre, Tel-Hashomer, Israel
| | | | - Maria M Santoro
- Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Santiago Ávila-Ríos
- Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico; Centro de Investigaciones en Enfermedades Infecciosas, Mexico City, Mexico
| | - Joseph Fokam
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé, Cameroon; Faculty of Health Science, University of Buea, Buea, Cameroon; National HIV Drug Resistance Working Group, Ministry of Public Health, Yaoundé, Cameroon
| | - Andrew Phillips
- Institute for Global Health, University College London, London, UK
| | - Robert W Shafer
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Michael R Jordan
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; Tufts Center for Integrated Management of Antimicrobial Resistance, Tufts University School of Medicine, Boston, MA, USA
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3
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Maggiorella MT, Sernicola L, Picconi O, Pizzi E, Belli R, Fulgenzi D, Rovetto C, Bruni R, Costantino A, Taffon S, Chionne P, Madonna E, Pisani G, Borsetti A, Falvino C, Ranieri R, Baccalini R, Pansera A, Castelvedere F, Babudieri S, Madeddu G, Starnini G, Dell'Isola S, Cervellini P, Ciccaglione AR, Ensoli B, Buttò S. Epidemiological and molecular characterization of HBV and HCV infections in HIV-1-infected inmate population in Italy: a 2017-2019 multicenter cross-sectional study. Sci Rep 2023; 13:14908. [PMID: 37689795 PMCID: PMC10492787 DOI: 10.1038/s41598-023-41814-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
HBV/HCV co-infection is common in HIV-1-infected prisoners. To investigate the characteristics of HIV co-infections, and to evaluate the molecular heterogeneity of HIV, HBV and HCV in prisoners, we carried-out a multicenter cross-sectional study, including 65 HIV-1-infected inmates enrolled in 5 Italian detention centers during the period 2017-2019. HIV-1 subtyping showed that 77.1% of inmates were infected with B subtype and 22.9% with non-B subtypes. Italian nationals were all infected with subtype B (93.1%), except two individuals, one infected with the recombinant form CRF72_BF1, and the other with the HIV-1 sub-subtype A6, both previously not identified in inmates of Italian nationality. Non-Italian nationals were infected with subtype B (52.6%), CRFs (36.8%) and sub-subtypes A1 and A3 (5.2%). HIV variants carrying resistance mutations to NRTI, NNRTI, PI and InSTI were found in 7 inmates, 4 of which were never exposed to the relevant classes of drugs associated with these mutations. HBV and/or HCV co-infections markers were found in 49/65 (75.4%) inmates, while 27/65 (41.5%) showed markers of both HBV and HCV coinfection. Further, Italian nationals showed a significant higher presence of HCV markers as compared to non-Italian nationals (p = 0.0001). Finally, HCV phylogenetic analysis performed in 18 inmates revealed the presence of HCV subtypes 1a, 3a, 4d (66.6%, 16.7% and 16.7%, respectively). Our data suggest the need to monitor HIV, HBV and HCV infections in prisons in order to prevent spreading of these viruses both in jails and in the general population, and to implement effective public health programs that limit the circulation of different genetic forms as well as of viral variants with mutations conferring resistance to treatment.
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Affiliation(s)
- Maria Teresa Maggiorella
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy.
| | - L Sernicola
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
| | - O Picconi
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
| | - E Pizzi
- Core Facilities, Istituto Superiore di Sanità, Rome, Italy
| | - R Belli
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
| | - D Fulgenzi
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
| | - C Rovetto
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
| | - R Bruni
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - A Costantino
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - S Taffon
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - P Chionne
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - E Madonna
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - G Pisani
- National Center for Immunobiologicals, Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - A Borsetti
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
| | - C Falvino
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
| | - R Ranieri
- Infectious Diseases Service, Penitentiary Health System, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | | | | | | | - S Babudieri
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - G Madeddu
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - G Starnini
- Belcolle Hospital, ASL Viterbo, Viterbo, Italy
| | | | | | - A R Ciccaglione
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - B Ensoli
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
| | - S Buttò
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161, Rome, Italy
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O'Connor C, Leyritana K, Doyle AM, Lewis JJ, Gill R, Salvaña EM. Interactive Mobile Phone HIV Adherence Support for Men Who Have Sex With Men in the Philippines Connect for Life Study: Mixed Methods Approach to Intervention Development and Pilot Testing. JMIR Form Res 2022; 6:e30811. [PMID: 35113030 PMCID: PMC8855294 DOI: 10.2196/30811] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The HIV epidemic in the Philippines is one of the fastest growing epidemics globally, and infections among men who have sex with men are rising at an alarming rate. The World Health Organization recommends the use of mobile health (mHealth) technologies to engage patients in care and ensure high levels of adherence to antiretroviral therapy (ART). Existing mHealth interventions can be adapted and tailored to the context and population served. OBJECTIVE This study aims to create a locally tailored intervention using a mobile phone platform to support treatment adherence for HIV patients on ART in the Philippines. METHODS A mixed methods approach guided by the Behavior Change Wheel framework was used to adapt an existing mHealth adherence support platform for the local setting and target population. A literature review, retrospective clinical record review, and focus group discussions with patients were conducted to understand the drivers of ART adherence and tailor the intervention accordingly. The resulting intervention was pilot-tested for 8 weeks, followed by focus group discussions with patients who received the intervention to assess the acceptability of the design. RESULTS Key issues contributing to nonadherence included side effects, lack of behavioral skills for pill taking, social support, mental health, and substance use. Patients identified mHealth as an acceptable mode of intervention delivery and wanted mHealth services to be highly personalizable. The study team, clinicians, and software developers integrated these findings into the intervention, which included a menu of services as follows: pill reminders, health tips, adherence feedback, appointment reminders, and symptom reporting. During the pilot phase, technical issues in the interactive voice response system (IVRS) were identified and addressed. Patients who participated in the pilot phase expressed a preference for SMS text messaging over the IVRS. Patients responded positively to the appointment reminders and health tips, whereas patient feedback on daily and weekly pill reminders and adherence feedback was mixed. CONCLUSIONS The mobile phone-based SMS text messaging and IVRS intervention was acceptable to men who have sex with men in Manila, the Philippines, and qualitative analysis suggested that the intervention helped promote ART adherence and appointment attendance.
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Affiliation(s)
- Cara O'Connor
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines
| | - Katerina Leyritana
- Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines
| | - Aoife M Doyle
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - James J Lewis
- Y Lab, The Public Services Innovation Lab for Wales, School of Social Sciences, Cardiff University, Cardiff, United Kingdom
| | - Randeep Gill
- Johnson & Johnson Global Public Health, London, United Kingdom
| | - Edsel Maurice Salvaña
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila, Ermita, Philippines.,Division of Infectious Diseases (Global Health), Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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5
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Muccini C, Pinyakorn S, Sirivichayakul S, Kroon E, Sacdalan C, Crowell TA, Trichavaroj R, Ananworanich J, Vasan S, Phanuphak N, Colby DJ. Brief Report: Prevalence Trend of Transmitted Drug Resistance in a Prospective Cohort of Thai People With Acute HIV Infection. J Acquir Immune Defic Syndr 2021; 87:1173-1177. [PMID: 34229330 PMCID: PMC8260960 DOI: 10.1097/qai.0000000000002718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The greater availability of different antiretroviral therapy regimens in developing countries may influence the emergence of transmitted drug resistance (TDR). People with acute HIV infection (AHI) represent the best opportunity for real-time monitoring of TDR. This study assessed the TDR prevalence trends over time in a Thai cohort of predominantly men who have sex with men (MSM) with AHI. METHODS At the time of RV254/SEARCH010 study (NCT00796146) enrollment and before starting ART, HIV genotyping was used to identify mutations in the reverse transcriptase and protease genes. Testing for TDR mutations was obtained by a validated in-house method with TRUGENE assay in a subset. Genotype sequences were analyzed using the Stanford University HIV Drug Resistance Database. RESULTS Genotyping was performed for 573 participants with AHI. Their median age was 26 years (interquartile range 22-31), 97.4% were men, and 94.1% were MSM. Overall TDR prevalence was 7.0%, declining from 12.5% in 2009-2010 to 4.8% in 2017-2018. A declining resistance prevalence to nonnucleoside reverse transcriptase inhibitor emerged from 9.4% in 2009-2010 to 3.5% in 2017-2018 and to nucleoside reverse transcriptase inhibitor from 6.3% to 2.1%. Protease inhibitor resistance showed a decreased TDR level from 3.1% in 2009-2010 to 1.4% in 2017-2018. CONCLUSIONS We report an encouraging declining trend in TDR prevalence in a Thai cohort of mainly MSM from 2009 to 2018; in 2017-2018, we observed a low TDR prevalence according to the World Health Organization definition.
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Affiliation(s)
- Camilla Muccini
- Vita-Salute San Raffaele University, Milan, Italy
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Suteeraporn Pinyakorn
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Sunee Sirivichayakul
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Eugene Kroon
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - Carlo Sacdalan
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - Trevor A. Crowell
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Rapee Trichavaroj
- Institute of HIV Research and Innovation, Bangkok, Thailand
- Department of Retrovirology, Armed Forces Research Institute of Medical Sciences _ US Component, Bangkok, Thailand
| | - Jintanat Ananworanich
- Department of Global Health, the University of Amsterdam, Amsterdam, The Netherlands
| | - Sandhya Vasan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Nittaya Phanuphak
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - Donn J. Colby
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Institute of HIV Research and Innovation, Bangkok, Thailand
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Haankuku U, Njuho P. The Estimation of Transmitted Drug Resistance Mutation Strains Probability in the Treatment of HIV Using the Beta-Binomial Model. AIDS Res Hum Retroviruses 2021; 37:468-477. [PMID: 33198497 DOI: 10.1089/aid.2020.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The human immunodeficiency virus (HIV) is a viral infection that destroys the human immune system resulting in acquired immunodeficiency syndrome (AIDS). The Zambia HIV prevalence rate (11.3%) remains among the highest in the sub-Saharan Africa. In the treatment of HIV-naive patients, a problem that relates to the transmitted drug resistance mutation strains (TDRMs) occurs in the administration of antiretroviral (ARV) drugs. To address this problem, we propose the use of transition probabilities when prescribing a switch from the first-line to the second-line or to the third-line regimen on the ARV drugs combination. We formulate a statistical technique to determine an optimal ARV drugs combination. To compute a transition probability matrix chart on ARV drugs combinations of the first-line and second-line regimens, we apply a beta-binomial hierarchical model on HIV data. The transition probability matrices corresponding to the ARV drugs combinations TDF+ETC+NVP, TDF+FTC+EFV, AZT+3TC+NVP, AZT+3TC+EFV, D4T+3TC+NVP, and D4T+3TC+EFV provide an upper triangular matrix of probabilities. We observe a higher probability of remaining in the same regimen state than moving to another state. A transition probability chart provides information on the most effective combination to prescribe to a patient in the presence of transmitted drug resistance mutation (TDRM) test results. The transmission probabilities play a major role in aiding the physicians make an informed decision to prescribe an optimal ARV drugs combination. We suggest a TDRM test to be carried out to all newly diagnosed HIV individuals before prescribing any of the ARV drugs combination.
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Affiliation(s)
- Urban Haankuku
- Department of Statistics, University of Zambia, Lusaka, Zambia
| | - Peter Njuho
- Department of Statistics, University of South Africa, Johannesburg, South Africa
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7
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High HIV-1 diversity in immigrants resident in Italy (2008-2017). Sci Rep 2020; 10:3226. [PMID: 32094387 PMCID: PMC7039940 DOI: 10.1038/s41598-020-59084-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/23/2019] [Indexed: 02/02/2023] Open
Abstract
The proportion of new diagnoses of HIV infection in immigrants residing in Italy raised from 11% in 1992 to 29.7% in 2018. To investigate the HIV clades circulating in this community a retrospective study was performed in 557 HIV-infected immigrants living in 12 Italian cities. Immigrants originated from East-Europe and Central-Asia (11.7%), North Africa and Middle East (7.3%), South and South-East Asia (7.2%), Latin America and the Caribbean (14.4%), and sub-Saharan Africa (59.4%). More than 87% of immigrants were on antiretroviral therapy (ART), although 26.6% of them were viremic. A 22.0% of immigrants had hepatitis (HBV and/or HCV) and/or tuberculosis. HIV phylogenetic analysis on sequences from 192 immigrants showed the presence of clades B (23.4%), G (16.1%), C (10.4%), A1 (9.4%), F1 (5.2%), D (1.6%) and Circulating Recombinant Forms (CRFs) (33.9%). CRF02_AG represented 72.3% of the total CRFs. Clusters between immigrants and Italian natives were also present. Drug resistance mutations to NRTI, NNRTI, and PI drug classes occurred in 29.1% of ART-treated and in 12.9% of ART-naïve individuals. These data highlight the need for tailored public health interventions in immigrants to avoid spreading in Italy of HIV genetic forms and ART-resistant variants, as well as HIV co-morbidities.
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8
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Sapozhnikov J, Young JD, Patel M, Chiampas TD, Vaughn P, Badowski ME. Prevalence of HIV-1 transmitted drug resistance in the incarcerated population. HIV Med 2017; 18:756-763. [PMID: 28585361 DOI: 10.1111/hiv.12522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the study was to determine the prevalence of transmitted drug resistance (TDR)-associated mutations among treatment-naïve, incarcerated individuals with HIV-1 infection in the USA as well as the class TDR and antiretroviral (ARV) mutations present at baseline. METHODS Patients over the age of 18 years were included in the study if they had been diagnosed with HIV infection, if their HIV infection was managed through telemedicine and if they were incarcerated in the State of Illinois Department of Corrections between 10 July 2010 and 29 April 2016. Additionally, the patients were required to have a documented genotype and be ARV-naïve. A medical chart review was conducted to assess demographic information, disease burden, and risk factors for acquiring the virus. RESULTS The inclusion criteria were met for 105 patients. A total of 24 patients (23%) had a clinically significant mutation associated with resistance to any drug class. The prevalence of mutations conferring clinically significant resistance was 19% for nonnucleoside reverse transcriptase inhibitors (NNRTIs), 18% for nucleoside reverse transcriptase inhibitors (NRTIs), and 4% for protease inhibitors (PIs). Five per cent of patients had dual-class TDR to both NRTI and NNRTI drug classes and 2% of patients had mutations to both NNRTI and PI drug classes. There was no significant increase in the prevalence of clinically relevant drug resistance mutations based on demographics, burden of disease, or risk factors for acquiring the virus. CONCLUSIONS A high prevalence of TDR was identified in the ARV-naïve incarcerated population. The results of this study indicate an increased prevalence of TDR in a largely unstudied incarcerated population, demonstrating the need for increased monitoring of resistance in HIV-infected patients world-wide.
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Affiliation(s)
- J Sapozhnikov
- College of Pharmacy, Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA
| | - J D Young
- Division of Infectious Diseases, Immunology and International Medicine, Department of Medicine, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | - M Patel
- Division of Infectious Diseases, Immunology and International Medicine, Department of Medicine, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | - T D Chiampas
- College of Pharmacy, Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA
| | - P Vaughn
- College of Pharmacy, Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA
| | - M E Badowski
- College of Pharmacy, Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA
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Sanarico N, D’Amato S, Bruni R, Rovetto C, Salvi E, Di Zeo P, Chionne P, Madonna E, Pisani G, Costantino A, Equestre M, Tosti ME, Cenci A, Maggiorella MT, Sernicola L, Pontali E, Pansera A, Quattrocchi R, Carbonara S, Signorile F, Surace LA, Federzoni G, Garlassi E, Starnini G, Monarca R, Babudieri S, Rapicetta M, Pompa MG, Caraglia A, Ensoli B, Ciccaglione AR, Buttò S. Correlates of infection and molecular characterization of blood-borne HIV, HCV, and HBV infections in HIV-1 infected inmates in Italy: An observational cross-sectional study. Medicine (Baltimore) 2016; 95:e5257. [PMID: 27858889 PMCID: PMC5591137 DOI: 10.1097/md.0000000000005257] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Coinfection of blood-borne hepatitis B and hepatitis C viruses (HBV and HCV, respectively) in human immunodeficiency virus type 1 (HIV-1)-positive individuals frequently occurs in inmate population and peculiar viral strains and patterns of virological markers may be observed.Plasma from 69 HIV-1-positive inmates was obtained from 7 clinical centers connected with correctional centers in different towns in Italy. HIV, HBV, and HCV markers were tested by commercial assays. Virus genotyping was carried out by sequencing the protease and reverse transcriptase-encoding region (PR-RT region) for HIV and a region encompassing the NS5B gene for HCV and subsequent phylogenetic analysis.Twelve over 14 HIV-subtyped inmates were infected with HIV-1 subtype B strains. The 2 non-B strains belonged to subtype G and CRF02_AG, in an Italian and a Gambian patient, respectively. Variants carrying the K103N and Y181C resistance mutations to non-nucleoside reverse transcriptase inhibitors (NNRTIs) were found in 2 out of 9 patients naive for combined antiretroviral therapy (cART) (22.2%). Most HIV-positive patients (92.8%) showed evidence of past or present HBV and/or HCV infection. Prevalence of HBV and HCV was 81.2% for both viruses, whereas prevalence of HBV/HCV coinfection was 69.6%. A significantly higher presence of HCV infection was found in Italians [odds ratio (OR) 11.0; interval 1.7-80.9] and in drug users (OR 27.8; interval 4.9-186.0). HCV subtypes were determined in 42 HCV or HBV/HCV-coinfected individuals. HCV subtypes 1a, 3a, 4d, and 1b were found in 42.9%, 40.5%, 14.3%, and 2.4% of inmates, respectively. Low titers of HBV DNA in HBV DNA positive subjects precluded HBV subtyping.The high prevalence of HBV and HCV coinfections in HIV-infected inmates, as well as the heterogeneity of HIV and HCV subtypes suggest the need to adopt systematic controls in prisons to monitor both the burden and the genetic forms of blood-borne viral infections, in order to apply targeted therapeutic interventions.
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Affiliation(s)
| | | | - Roberto Bruni
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | | | - Emanuela Salvi
- National AIDS Center, Istituto Superiore di Sanità, Rome
| | | | - Paola Chionne
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | | | - Giulio Pisani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | - Angela Costantino
- National AIDS Center, Istituto Superiore di Sanità, Rome
- Italian Ministry of Health, Rome
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | - Michele Equestre
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | - Maria E. Tosti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | | | | | | | - Emanuele Pontali
- ASL 3 Genovese and Department of Infectious Diseases, Galliera Hospital, Genova
| | | | | | | | | | - Lorenzo Antonio Surace
- Centro Medicina del Viaggiatore e delle Migrazioni, Presidio Ospedaliero di Lamezia Terme, Giovanni Paolo II Hospital, Lamezia Terme
| | | | | | | | | | | | - Maria Rapicetta
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | | | | | - Barbara Ensoli
- National AIDS Center, Istituto Superiore di Sanità, Rome
| | | | - Stefano Buttò
- National AIDS Center, Istituto Superiore di Sanità, Rome
- Correspondence: Stefano Buttò, National AIDS Center, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161 Rome, Italy (e-mail: )
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