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PHYLOGENETIC TRACKING of HIV EPIDEMIC GROWTH in QUEBEC from 2014 to 2020
Topics in Antiviral Medicine ; 30(1 SUPPL):314-315, 2022.
Article in English | EMBASE | ID: covidwho-1880037
ABSTRACT

Background:

Ending the HIV Epidemic by 2030 initiative includes phylogenetics as a molecular framework to track patterns of HIV spread. In this study, phylogenetics was combined with available epidemiological data to elucidate track evolving trends in HIV-1 spread among Men having Sex with Men (MSM) and Heterosexual (HET) populations in Quebec.

Methods:

Phylogenetic linkage analysis was performed using MEGA-10 and HIV-TRACE/Microbe-TRACE methodologies. New infections genotyped between 2014-2020 were stratified into groups i) Subtype B MSM (subtype B male singletons/male-male clusters, n=1812);ii) Subtype B Heterosexual (female singletons/female-male clusters, n=432), including migrants from the Caribbean and Americas;and iii) Non-B subtype (n=737) epidemics. Test requisition data and clinical data from Clinique Actuel (n=141 and 50, 2016-2018) monitored epidemiological features in a subset of newly diagnosed persons.

Results:

Among MSM, annual new infections declined by 20% and 40% over the 2015-2017 and 2018-2020 periods, respectively. Overall, 45% of new infections in MSM were associated with 20 active large clusters, adding 8-96 infections/clusters from 2014-2020. Clinical data showed 37% newly diagnosed MSM were born outside Canada, 28% of whom were linked to large cluster outbreaks. Among heterosexuals with subtype B infections, there was a 31% increase from 2015-2017 followed by a 36% decline from 2018-2020 post-COVID. Of note, large cluster HET outbreaks occurred in Quebec City, Richelieu, and Northern Quebec Overall, non-B subtype infections remained steady (median 100 annually) over the 2014 to 2020 period. Several non-B subtype clusters reflect the domestic introduction and spread of subtype CRF02- AG variants. Cluster membership and cluster size was associated with recent stage infection, viral sequence recency (based on % mixed base calls) and younger age of members within individual clusters.

Conclusion:

Annual numbers of new HIV-1 infections have steadily declined among MSM post-2008, concomitant to improved HIV prevention paradigms. Epidemic control among MSM and HET groups has been thwarted by large cluster outbreaks. Recent arrivals to Quebec accounted for a growing number of subtype B and non-B subtype infections. HIV prevention efforts must continue in the post-COVID era, tailored to avert transmission cascades in younger persons and recent migrant populations.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Topics in Antiviral Medicine Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Topics in Antiviral Medicine Year: 2022 Document Type: Article