Earlier initiation of antiretroviral treatment coincides with an initial control of the HIV-1 sub-subtype F1 outbreak among men-having-sex-with-men in Flanders, Belgium
Vinken, L. (KU Leuven. Rega Institute for Medical Research)
Fransen, K. (Institute of Tropical Medicine Antwerp (Bèlgica))
Cuypers, L. (KU Leuven. Rega Institute for Medical Research)
Alexiev, I. (National Reference Confirmatory Laboratory of HIV. National Center of Infectious and Parasitic Diseases)
Balotta, C. (Infectious Diseases and Immunopathology Section. 'L. Sacco' Department of Biomedical and Clinical Sciences. 'L. Sacco' Hospital. University of Milan)
Debaisieux, L. (AIDS Reference Laboratory. CUB-Hopital Erasme. Université Libre de Bruxelles)
Seguin-Devaux, C. (Laboratory of Retrovirology. Department of Infection and Immunity. Luxembourg Institute of Health)
Ribas, S. G. (Institute of Tropical Medicine Antwerp (Bèlgica))
Gomes, P. (Centro de Investigação Interdisciplinar Egas Moniz. Instituto Universitário Egas Moniz)
Incardona, F. (EuResist Network GEIE)
Kaiser, Rolf (Institute of Virology. University of Cologne)
Ruelle, J. (Unit of Medical Microbiology. Institute of Experimental and Clinical Research. Université Catholique de Louvain)
Sayan, M. (Research Center of Experimental Health Sciences. Near East University)
Paraschiv, S. (Molecular Diagnostics Laboratory. National Institute for Infectious Diseases 'Matei Bals')
Paredes, Roger (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Peeters, Marc (UMI 233 TransVIHMI/INSERM1175. Institut de Recherche pour le Développement. University of Montpellier)
Sönnerborg, A. (Karolinska Institutet (Estocolm, Suècia). Department of Laboratory Medicine)
Vancutsem, E. (AIDS Reference Laboratory. Department of Microbiology and Infection Control. Universitair Ziekenhuis Brussel)
Vandamme, A. M. (Unidade de Microbiologia. Center for Global Health and Tropical Medicine. Instituto de Higiene e Medicina Tropical. Universidade Nova de Lisboa)
Van den Wijngaert, S. (AIDS Reference Laboratory. Department of Microbiology. Saint-Pierre University Hospital)
Van Ranst, M. (University Hospitals Leuven (Bèlgica))
Verhofstede, C. (AIDS Reference Laboratory. Department of Clinical Chemistry. Microbiology and Immunology. Ghent University)
Stadler, T. (Swiss Institute of Bioinformatics)
Lemey, P. (KU Leuven. Rega Institute for Medical Research)
Van Laethem, K. (University Hospitals Leuven (Bèlgica))
Universitat Autònoma de Barcelona

Data:	2019
Resum:	Human immunodeficiency virus type 1 (HIV-1) non-B subtype infections occurred in Belgium since the 1980s, mainly amongst migrants and heterosexuals, whereas subtype B predominated in men-having-sex-with-men (MSM). In the last decade, the diagnosis of F1 sub-subtype in particular has increased substantially, which prompted us to perform a detailed reconstruction of its epidemiological history. To this purpose, the Belgian AIDS Reference Laboratories collected HIV-1 pol sequences from all sub-subtype F1-infected patients for whom genotypic drug resistance testing was requested as part of routine clinical follow-up. This data was complemented with HIV-1 pol sequences from countries with a high burden of F1 infections or a potential role in the global origin of sub-subtype F1. The molecular epidemiology of the Belgian subtype F1 epidemic was investigated using Bayesian phylogenetic inference and transmission dynamics were characterized based on birth-death models. F1 sequences were retained from 297 patients diagnosed and linked to care in Belgium between 1988 and 2015. Phylogenetic inference indicated that among the 297 Belgian F1 sequences, 191 belonged to a monophyletic group that mainly contained sequences from people likely infected in Belgium (OR 26. 67, 95% CI 9. 59-74. 15), diagnosed in Flanders (OR 7. 28, 95% CI 4. 23-12. 53), diagnosed at a recent stage of infection (OR 7. 19, 95% CI 2. 88-17. 95) or declared to be MSM (OR 34. 8, 95% CI 16. 0-75. 6). Together with a Spanish clade, this Belgian clade was embedded in the genetic diversity of Brazilian subtype F1 strains and most probably emerged after one or only a few migration events from Brazil to the European continent before 2002. The origin of the Belgian outbreak was dated back to 2002 (95% higher posterior density 2000-2004) and birth-death models suggested that its extensive growth had been controlled (R < 1) by 2012, coinciding with a time period where delay in antiretroviral treatment initiation substantially declined. In conclusion, phylogenetic reconstruction of the Belgian HIV-1 sub-subtype F1 epidemic illustrates the introduction and substantial dissemination of viral strains in a geographically restricted risk group that was most likely controlled by effective treatment as prevention.
Ajuts:	European Commission 725422 European Commission 335529
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Belgium ; HIV-1 ; Men-having-sex-with-men ; Hylodynamics+ ; Sub-subtype F1 ; Treatment as prevention
Publicat a:	Frontiers in microbiology, Vol. 10 (march 2019) , p. 613, ISSN 1664-302X

DOI: 10.3389/fmicb.2019.00613
PMID: 30972053

13 p, 4.9 MB

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