Identification of recent HIV-1 infection among newly diagnosed cases in Catalonia, Spain (2006-08).

BACKGROUND: Quantification and description of patients recently infected by HIV can provide an accurate estimate of the dynamics of HIV transmission. Between 2006 and 2008 in Catalonia, we estimated the prevalence of recent HIV infection among newly diagnosed cases, described the epidemiological characteristics of the infection according to whether it was recent, long-standing or advanced, and identified factors associated with recent infection. METHODS: A Test for Recent Infection (TRI) was performed in serum samples from patients newly diagnosed with HIV. Two different TRI were used: the Vironostika-LS assay (January 2006-May 2007) and the BED-CEIA CEIA (June 2007 onwards). Samples were obtained within the first 6 months of diagnosis. Patients whose samples tested positive in the TRI were considered recently infected. RESULTS: Of 1125 newly diagnosed patients, 79.9% were men (median age, 35.4 years), 38.7% were born outside Spain, 48.9% were men who have sex with men (MSM) and 10.6% presented other sexually transmitted infections. The overall percentage of recent infection was 23.0%, which increased significantly, from 18.1% in 2006 to 26.2% in 2008. This percentage was higher for patients from South America (27.6%). Factors associated with recent infection were acquiring infection through sexual contact between MSM [odds ratio (OR) 2.0; 95% confidence interval (95% CI) 1.1-3.9], compared with acquiring infection through heterosexual relations and being under 30 years of age (OR 5.9; 95% CI 1.9-17.4), compared with being over 50 years of age. CONCLUSION: The highest percentage of recent infection was identified in MSM, suggesting either a higher incidence or a greater frequency of HIV testing. Information regarding testing patterns is necessary to correctly interpret data from recently infected individuals. Systems to monitor the HIV epidemic should include both parameters.

Prevalence of Transmitted Antiretroviral Resistance and Distribution of HIV-1Subtypes Among Patients with Recent Infection in Catalonia (Spain) between2003 and 2005

Los objetivos de este estudio fueron evaluar la prevalencia de las resistencias primarias transmitidas (RPT)y de subtipos de VIH-1 en pacientes recientemente infectados en Cataluña entre 2003 y 2005, y describirlas características de estos pacientes según la presencia o ausencia de RPT y el subtipo de VIH-1.Métodos: Después de la aplicación del algoritmo de pruebas serológicas para la seroconversión reciente al VIH (STARHS), alícuotas residuales de las muestras de suero de individuos recientemente infectados no tratados previamente con antirretrovirales fueron genotipados. Las secuencias FASTA se analizaron conel programa HIV db. Se utilizó el listado de mutaciones de la Organización Mundial de la Salud del 2009para estimar la prevalencia de resistencias transmitidas. Resultados: De 182 pacientes recientemente infectados, 14 (7,7%) presentaron RPT. Siete personas (3,8%)presentaban evidencias genotípica de RPT a los inhibidores de la transcriptasa inversa no análogos anucleósidos, 6 (3,3%) frente a inhibidores de la transcriptasa inversa análogos de nucleósidos, 3 (1,6%)frente a los inhibidores de la proteasa, y solo 2 personas (1,1%) presentaron RPT a más de una familia de medicamentos. Treinta y cinco (19,2%) pacientes estaban infectados con un subtipo no-B del VIH-1.Conclusión: Este es el primer estudio que estima la prevalencia de RPT en pacientes recientemente infectadosen Cataluña, y los resultados son similares a los de estudios realizados en otras regiones españolas. Para el adecuado seguimiento de estos parámetros es necesaria la vigilancia epidemiológica sistemática de las RPT (AU)

Objectives: The objectives of this study were to assess the prevalence of transmitted HIV-1 drug resistances(TDR) and HIV-1 subtypes in recently infected patients in Catalonia between 2003 and 2005 and to describe the characteristics of these patients according to the presence or absence of TDR and HIV-1subtype.Methods: After application of the Serological Testing Algorithm for Recent HIV Seroconversion (STARHS),residual aliquots of serum samples from recently infected antiretroviral-naïve individuals were genotyped. FASTA sequences were analyzed using the HIVDB Program. The World Health Organization 2009List of Mutations for Surveillance of Transmitted HIV-1 Drug Resistant HIV Strains was used to estimate the prevalence of TDR. Results: Of 182 recently infected patients, 14 (7.7%) presented TDR. Seven (3.8%) had genotypic evidence of TDR against non-nucleoside reverse transcriptase inhibitors, 6 (3.3%) against nucleoside reverse transcriptase inhibitors, 3 (1.6%) against protease inhibitors (PIs), and only 2 individuals (1.1%) presented TDR against more than one class of drugs. Thirty-five (19.2%) patients were infected with a non-B HIV-1subtype.Conclusion: This is the first study to estimate the prevalence of TDR in recently infected patients in Catalonia. The results are similar to those of studies performed in other Spanish regions. Correct monitoring of these parameters requires systematic epidemiologic surveillance of transmitted resistance (AU)

Prevalence of transmitted antiretroviral resistance and distribution of HIV-1 subtypes among patients with recent infection in Catalonia (Spain) between 2003 and 2005.

OBJECTIVES: The objectives of this study were to assess the prevalence of transmitted HIV-1 drug resistances (TDR) and HIV-1 subtypes in recently infected patients in Catalonia between 2003 and 2005 and to describe the characteristics of these patients according to the presence or absence of TDR and HIV-1 subtype. METHODS: After application of the Serological Testing Algorithm for Recent HIV Seroconversion (STARHS), residual aliquots of serum samples from recently infected antiretroviral-naïve individuals were genotyped. FASTA sequences were analyzed using the HIVDB Program. The World Health Organization 2009 List of Mutations for Surveillance of Transmitted HIV-1 Drug Resistant HIV Strains was used to estimate the prevalence of TDR. RESULTS: Of 182 recently infected patients, 14 (7.7%) presented TDR. Seven (3.8%) had genotypic evidence of TDR against non-nucleoside reverse transcriptase inhibitors, 6 (3.3%) against nucleoside reverse transcriptase inhibitors, 3 (1.6%) against protease inhibitors (PIs), and only 2 individuals (1.1%) presented TDR against more than one class of drugs. Thirty-five (19.2%) patients were infected with a non-B HIV-1 subtype. CONCLUSION: This is the first study to estimate the prevalence of TDR in recently infected patients in Catalonia. The results are similar to those of studies performed in other Spanish regions. Correct monitoring of these parameters requires systematic epidemiologic surveillance of transmitted resistance.