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1. HIV incidence in the Estonian population in 2013 determined using the HIV-1 limiting antigen avidity assay

Author

Soodla, P., Simmons, R., Huik, K., Pauskar, M., Jõgeda, E. -L., Rajasaar, H., Kallaste, E., Maimets, M., Avi, R., Murphy, G., Porter, K., Lutsar, I., Del Amo, Julia, Meyer, Laurence, Bucher, Heiner C., Chêne, Geneviève, Hamouda, Osamah, Pillay, Deenan, Prins, Maria, Rosinska, Magda, Sabin, Caroline, Touloumi, Giota, Olson, Ashley, Cartier, Andrea, Fradette, Lorraine, Walker, Sarah, Babiker, Abdel, De Luca, Andrea, Fisher, Martin, Muga, Roberto, Kelleher, Tony, Cooper, David, Grey, Pat, Finlayson, Robert, Bloch, Mark, Ramacciotti, Tim, Gelgor, Linda, Smith, Don, Zangerle, Robert, Gill, John, Dabis, Francois, Thiebaut, Rodolphe, Costagliola, Dominique, Guiguet, Marguerite, Vanhems, Philippe, Chaix, Marie-Laure, Ghosn, Jade, Boufassa, Faroudy, Meixenberger, Karolin, Bannert, Norbert, Bartmeyer, Barbara, Antoniadou, Anastasia, Chrysos, Georgios, Daikos, Georgios L., Pantazis, Nikos, Katsarou, Olga, Rezza, Giovanni, Dorrucci, Maria, Monforte, Antonella d'Arminio, Geskus, Ronald, van der Helm, Jannie, Schuitemaker, Hanneke, Sannes, Mette, Brubakk, Oddbjorn, Kran, Anne-Marte Bakken, Rosinska, Magdalena, Tor, Jordi, de Olalla, Patricia Garcia, Cayla, Joan, Moreno, Santiago, Monge, Susana, del Romero, Jorge, Pérez-Hoyos, Santiago, Sönnerborg, Anders, Günthard, Huldrych, Scherrer, Alexandra, Malyuta, Ruslan, Johnson, Anne, Phillips, Andrew, Morrison, Charles, Price, Matt A., Giaquinto, Carlo, Grarup, Jesper, Kirk, Ole, Bailey, Heather, Volny Anne, Alain, Panteleev, Alex, Thorne, Claire, Aboulker, Jean-Pierre, Albert, Jan, Asandi, Silvia, De Wit, Stéphane, Reiss, Peter, Gatell, José, Karpov, Igor, Ledergerber, Bruno, Møller, Claus, Rakhmanova, Aza, Rockstroh, Jürgen, Sandhu, Manjinder, Dedes, Nikos, Pizzuti, David, Faggion, Silvia, Raben, Dorthe, Schwimmer, Christine, Scott, Martin, APH - Global Health, Infectious diseases, Epidemiology and Data Science, Experimental Immunology, APH - Aging & Later Life, and Global Health

Subjects
Male, 0301 basic medicine, HIV Infections, Immunoenzyme Techniques, 0302 clinical medicine, Epidemiology, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, media_common, Aged, 80 and over, education.field_of_study, Transmission (medicine), Incidence, Health Policy, Incidence (epidemiology), virus diseases, Middle Aged, 3. Good health, Infectious Diseases, Female, epidemiology, Viral load, Adult, Estonia, medicine.medical_specialty, Adolescent, 030106 microbiology, Population, Eastern Europe, recent infection testing algorithm, Young Adult, recent HIV infection, 03 medical and health sciences, Internal medicine, medicine, Humans, HIV serological assay, media_common.cataloged_instance, European union, Seroconversion, education, Aged, injecting drug users, Diagnostic Tests, Routine, business.industry, Public health, HIV, Immunology, HIV-1, business
Abstract

OBJECTIVES: Estonia has one the highest number of new HIV diagnoses in the European Union, mainly among injecting drug users and heterosexuals. Little is known of HIV incidence, which is crucial for limiting the epidemic. Using a recent HIV infection testing algorithm (RITA) assay, we aimed to estimate HIV incidence in 2013. METHODS: All individuals aged ≥18 years newly-diagnosed with HIV in Estonia January- December 2013, except blood donors and those undergoing antenatal screening, were included. Demographic and clinical data were obtained from the Estonian Health Board and the Estonian HIV-positive patient database. Serum samples were tested for recent infection using the LAg-avidity EIA assay. HIV incidence was estimated based on previously published methods. RESULTS: Of 69,115 tested subjects, 286 (0.41%) were newly-diagnosed with HIV with median age of 33 years (IQR: 28–42) and 65% male. Self-reported routes of HIV transmission were mostly heterosexual contact (n = 157, 53%) and injecting drug use (n = 62, 21%); 64 (22%) were with unknown risk group. Eighty two (36%) were assigned recent, resulting in estimated HIV incidence of 0.06%, corresponding to 642 new infections in 2013 among the non-screened population. Incidence was highest (1.48%) among people who inject drugs. CONCLUSIONS: These high HIV incidence estimates in Estonia call for urgent action of renewed targeted public health promotion and HIV testing campaigns.

Published
2017
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2. The concordance of the limiting antigen and the Bio-Rad avidity assays in persons from Estonia infected mainly with HIV-1 CRF06_cpx

Author

Huik, Kristi Soodla, Pilleriin Pauskar, Merit Owen, S. Michele Luo, Wei Murphy, Gary Jogeda, Ene-Ly Kallas, Eveli Rajasaar, Heli Avi, Radko Masciotra, Silvina and Lutsar, Irja Del Amo, Julia Meyer, Laurence Bucher, Heiner C. Chene, Genevieve Hamouda, Osamah Pillay, Deenan and Prins, Maria Rosinska, Magda Sabin, Caroline Touloumi, Giota and Porter, Kholoud Olson, Ashley Cartier, Andrea Fradette, Lorraine Walker, Sarah Babiker, Abdel De Luca, Andrea and Fisher, Martin Muga, Roberto Kelleher, Tony Cooper, David and Grey, Pat Finlayson, Robert Bloch, Mark Ramacciotti, Tim and Gelgor, Linda Smith, Don Zangerle, Robert Gill, John and Dabis, Francois Thiebaut, Rodolphe Costagliola, Dominique and Guiguet, Marguerite Vanhems, Philippe Chaix, Marie-Laure and Ghosn, Jade Boufassa, Faroudy Meixenberger, Karolin Bannert, Norbert Bartmeyer, Barbara Antoniadou, Anastasia Chrysos, Georgios Daikos, Georgios L. Pantazis, Nikos Katsarou, Olga and Rezza, Giovanni Dorrucci, Maria Monforte, Antonella d'Arminio Geskus, Ronald van der Helm, Jannie Schuitemaker, Hanneke Sannes, Mette Dyrhol-Riise, Anne Ma Kran, Anne-Marte Bakken Rosinska, Magdalena Tor, Jordi de Olalla, Patricia Garcia Cayla, Joan del Amo, Julia Moreno, Santiago and Monge, Susana del Romero, Jorge Perez-Hoyos, Santiago and Sonnerborg, Anders Guenthard, Huldrych Scherrer, Alexandra and Malyuta, Ruslan Johnson, Anne Phillips, Andrew Morrison, Charles Salata, Robert Mugerwa, Roy Chipato, Tsungai and Price, Matt A. Gilmour, Jill Kamali, Anatoli Karita, Etienne and Burns, Fiona Giaquinto, Carlo Grarup, Jesper Kirk, Ole and Bailey, Heather Anne, Alain Volny Panteleev, Alex and Thorne, Claire Aboulker, Jean-Pierre Albert, Jan Asandi, Silvia De Wit, Stephane Reiss, Peter Gatell, Jose and Karpov, Igor Ledergerber, Bruno Lundgren, Jens Moller, Claus and Rakhma-nova, Aza Rockstroh, Juergen Sandhu, Manjinder and Dedes, Nikos Fenton, Kevin Pizzuti, David Vitoria, Marco and Faggion, Silvia Frost, Richard Raben, Dorthe Schwimmer, Christine Scott, Martin CASCADE Collaboration EuroCoord

Abstract

Background Serological assays to determine HIV incidence have contributed to estimates of HIV incidence, monitoring of HIV spread, and evaluation of prevention strategies. Two frequently used incidence assays are the Sedia HIV-1 LAg-Avidity EIA (LAg) and the Bio-Rad avidity incidence (BRAI) assays with a mean duration of recent infection (MDRI) of 130 and 240 days for subtype B infections, respectively. Little is known about how these assays perform with recombinant HIV-1 strains. We evaluated the concordance of these assays in a population infected mainly with HIV-1 CRF06_cpx. Material/Methods Remnant serum samples (n = 288) collected from confirmed, newly-diagnosed HIV-positive persons from Estonia in 2013 were tested. Demographic and clinical data were extracted from clinical databases. LAg was performed according to the manufacturer’s protocol and BRAI testing was done using a validated protocol. Samples with LAg-pending or BRAI-invalid results were reclassified as recent if they were from persons with viral loads

Published
2019

3. A Phylogenetic Analysis of Human Immunodeficiency Virus Type 1 Sequences in Kiev: Findings Among Key Populations

Author

Fearnhill, Esther, Gourlay, Annabelle, Malyuta, Ruslan, Simmons, Ruth, Ferns, R Bridget, Grant, Paul, Nastouli, Eleni, Karnets, Iryna, Murphy, Gary, Medoeva, Antonia, Kruglov, Yuri, Yurchenko, Alexander, Porter, Kholoud, Del Amo, Julia, Meyer, Laurence, Bucher, Heiner C, Chêne, Geneviève, Hamouda, Osamah, Pillay, Deenan, Prins, Maria, Rosinska, Magda, Sabin, Caroline, Touloumi, Giota, Olson, Ashley, Cartier, Andrea, Fradette, Lorraine, Walker, Sarah, Babiker, Abdel, De Luca, Andrea, Fisher, Martin, Muga, Roberto, Kelleher, Tony, Cooper, David, Grey, Pat, Finlayson, Robert, Bloch, Mark, Ramacciotti, Tim, Gelgor, Linda, Smith, Don, Zangerle, Robert, Gill, John, Lutsar, Irja, Dabis, Francois, Thiebaut, Rodolphe, Costagliola, Dominique, Guiguet, Marguerite, Vanhems, Philippe, Chaix, Marie-Laure, Ghosn, Jade, Boufassa, Faroudy, Meixenberger, Karolin, Bannert, Norbert, Bartmeyer, Barbara, Antoniadou, Anastasia, Chrysos, Georgios, Daikos, Georgios L, Pantazis, Nikos, Katsarou, Olga, Rezza, Giovanni, Dorrucci, Maria, d’Arminio Monforte, Antonella, Geskus, Ronald, van der Helm, Jannie, Schuitemaker, Hanneke, Sannes, Mette, Brubakk, Oddbjorn, Bakken Kran, Anne-Marte, Rosinska, Magdalena, Tor, Jordi, Garcia de Olalla, Patricia, Cayla, Joan, del Amo, Julia, Moreno, Santiago, Monge, Susana, del Romero, Jorge, Pérez-Hoyos, Santiago, Sönnerborg, Anders, Günthard, Huldrych, Scherrer, Alexandra, Johnson, Anne, Phillips, Andrew, Morrison, Charles, Salata, Robert, Mugerwa, Roy, Chipato, Tsungai, Price, Matt A, Gilmour, Jill, Kamali, Anatoli, Karita, Etienne, Burns, Fiona, Giaquinto, Carlo, Grarup, Jesper, Kirk, Ole, Bailey, Heather, Volny Anne, Alain, Panteleev, Alex, Thorne, Claire, Aboulker, Jean-Pierre, Albert, Jan, Asandi, Silvia, De Wit, Stéphane, Reiss, Peter, Gatell, José, Karpov, Igor, Ledergerber, Bruno, Lundgren, Jens, Møller, Claus, Rakhmanova, Aza, Rockstroh, Jürgen, Sandhu, Manjinder, Dedes, Nikos, Fenton, Kevin, Pizzuti, David, Vitoria, Marco, Faggion, Silvia, Frost, Richard, Raben, Dorthe, Schwimmer, Christine, and Scott, Martin

Abstract

Background: The human immunodeficiency virus (HIV) epidemic in Ukraine has been driven by a rapid rise among people who inject drugs, but recent studies have shown an increase through sexual transmission. Methods: Protease and reverse transcriptase sequences from 876 new HIV diagnoses (April 2013–March 2015) in Kiev were linked to demographic data. We constructed phylogenetic trees for 794 subtype A1 and 64 subtype B sequences and identified factors associated with transmission clustering. Clusters were defined as ≥2 sequences, ≥80% local branch support, and maximum genetic distance of all sequence pairs in the cluster ≤2.5%. Recent infection was determined through the limiting antigen avidity enzyme immunoassay. Sequences were analyzed for transmitted drug resistance mutations. Results Thirty percent of subtype A1 and 66% of subtype B sequences clustered. Large clusters (maximum 11 sequences) contained mixed risk groups. In univariate analysis, clustering was significantly associated with subtype B compared to A1 (odds ratio [OR], 4.38 [95% confidence interval {CI}, 2.56–7.50]); risk group (OR, 5.65 [95% CI, 3.27–9.75]) for men who have sex with men compared to heterosexual males; recent, compared to long-standing, infection (OR, 2.72 [95% CI, 1.64–4.52]); reported sex work contact (OR, 1.93 [95% CI, 1.07–3.47]); and younger age groups compared with age ≥36 years (OR, 1.83 [95% CI, 1.10–3.05] for age ≤25 years). Females were associated with lower odds of clustering than heterosexual males (OR, 0.49 [95% CI, .31–.77]). In multivariate analysis, risk group, subtype, and age group were independently associated with clustering (P < .001, P = .007, and P = .033, respectively). Eighteen sequences (2.1%) indicated evidence of transmitted drug resistance. Conclusions Our findings suggest high levels of transmission and bridging between risk groups.

Published
2017

4. CD4 T cell decline following HIV seroconversion in individuals with and without CXCR4-tropic virus

Author

Ghosn, Jade, Bayan, Tatiana, Meixenberger, Karolin, Tran, Laurent, Frange, Pierre, Monforte, Antonella d'Arminio, Zangerle, Robert, de Mendoza, Carmen, Krastinova, Evguenia, Porter, Kholoud, Meyer, Laurence, Chaix, Marie-Laure, Burns, Fiona, Chene, Geneviãve, Costagliola, Dominique, Giaquinto, Carlo, Grarup, Jesper, Kirk, Ole, Bailey, Heather, Anne, Alain Volny, Panteleev, Alex, Phillips, Andrew, Thorne, Claire, Aboulker, Jean-Pierre, Albert, Jan, Asandi, Silvia, Cene, Geneviãve, De Wit, Stã©phane, Reiss, Peter, Del Amo, Julia, Gatell, Josã©, Hamouda, Osamah, Karpov, Igor, Ledergerber, Bruno, Lundgren, Jens, Malyuta, Ruslan, Mã¸ller, Claus, Prins, Maria, Rakhmanova, Aza, Rockstroh, Jã¼rgen, Rosinska, Magda, Sandhu, Manjinder, Touloumi, Giota, Dedes, Nikos, Fenton, Kevin, Pizzuti, David, Vitoria, Marco, Fradette, Lorraine, Frost, Richard, Cartier, Andrea, Raben, Dorthe, Schwimmer, Christine, Scott, Martin, AII - Infectious diseases, APH - Global Health, Infectious diseases, Amsterdam institute for Infection and Immunity, APH - Methodology, Epidemiology and Data Science, Other departments, and Experimental Immunology

Subjects
Adult, CD4-Positive T-Lymphocytes, Male, 0301 basic medicine, Microbiology (medical), Receptors, CXCR4, Anti-HIV Agents, viruses, 030106 microbiology, HIV Infections, Virus, Cohort Studies, 03 medical and health sciences, HIV Seropositivity, HIV tropism, Humans, Medicine, Pharmacology (medical), Seroconversion, Tropism, Pharmacology, business.industry, env Gene Products, Human Immunodeficiency Virus, virus diseases, Viral Load, Virology, CD4 Lymphocyte Count, Log-rank test, Kinetics, Viral Tropism, Infectious Diseases, Disease Progression, HIV-1, Tissue tropism, Female, business, Viral load, Cohort study
Abstract

Background The natural clinical and immunological courses following HIV seroconversion with CXCR4-tropic or dual-mixed (X4/DM) viruses are controversial. We compared spontaneous immunological outcome in patients harbouring an X4/DM virus at the time of seroconversion with those harbouring a CCR5-tropic (R5) virus. Methods Data were included from patients participating in CASCADE, a large cohort collaboration of HIV seroconverters, with ≥2 years of follow-up since seroconversion. The HIV envelope gene was sequenced from frozen plasma samples collected at enrolment, and HIV tropism was determined using Geno2Pheno (false-positive rate 10%). The spontaneous CD4 T cell evolution was compared by modelling CD4 kinetics using linear mixed-effects models with random intercept and random slope. Results A total of 1387 patients were eligible. Median time between seroconversion and enrolment was 1 month (range 0-3). At enrolment, 202 of 1387 (15%) harboured an X4/DM-tropic virus. CD4 decrease slopes were not significantly different according to HIV-1 tropism during the first 30 months after seroconversion. No marked change in these results was found after adjusting for age, year of seroconversion and baseline HIV viral load. Time to antiretroviral treatment initiation was not statistically different between patients harbouring an R5 (20.76 months) and those harbouring an X4/DM-tropic virus (22.86 months, logrank test P = 0.32). Conclusions: In this large cohort collaboration, 15% of the patients harboured an X4/DM virus close to HIV seroconversion. Patients harbouring X4/DM-tropic viruses close to seroconversion did not have an increased risk of disease progression, estimated by the decline in CD4 T cell count or time to combined ART initiation.

Published
2017

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