Using phylogenetic surveillance and epidemiological data to understand the HIV-1 transmission dynamics in French Guiana

Arantes, Ighor; Bello, Gonzalo; Darcissac, Edith; Lacoste, Vincent

doi:10.1097/qad.0000000000002817

Cited by 10 publications

(12 citation statements)

References 24 publications

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“…We have shown that in French Guiana Bcar lineages are predominant over B pandemic lineages (25,26). In Brazil, B pandemic lineages (and to a far lesser degree F) largely predominate; the 3 Brazilian states that have the greatest proportion of Bcar lineages are Maranhao, Roraima, and Amazonas (27), areas that are notoriously linked to gold mining and where many garimpeiros come from, notably, for French Guiana, Maranhao.…”

Section: Results Of the Review Of Available Information Hiv/aidsmentioning

confidence: 88%

Sexually transmitted infections on the border between Brazil and French Guiana

Divino

Leborgne

Correa³

et al. 2023

Front. Public Health

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PurposeThe border between the State of Amapa, Brazil, and French Guiana is mostly primary forest. In the Oyapock basin, socioeconomic circumstances have fueled sex work, gold mining and the circulation of sexually transmitted infections. Given the lack of comprehensive data on this border area, we describe the different sexually transmitted infections along the Brazil/French Guiana border and the testing and care activity.MethodsWe conducted a review of the available scientific and technical literature on sexually transmitted infections in this complex border area. Temporal trends were graphed and for Human Immunodeficiency Virus (HIV) we estimated incidence using the European Center for prevention and Disease Control modeling tool.ResultsUntil 2019, 26 of the 46 HIV-infected patients followed and treated in Saint Georges de l'Oyapock were residing on the Brazilian side in Oiapoque. Virological suppression was only achieved for 75% of treated patients; but dropped to 62% during the COVID-19 epidemic. In 2019, cooperation efforts allowed HIV care in Oiapoque, resulting in the transfer of Brazilian patients previously followed on the French side and a substantial increase in the number of patients followed in Oiapoque. The average yearly HIV serological testing activity at the health center in Saint Georges was 16 tests per 100 inhabitants per year; in Camopi it was 12.2 per 100 inhabitants. Modeling estimated the number of persons living with HIV around 170 persons, corresponding to a prevalence of 0.54% and about 40 undiagnosed infections. The model also suggested that there were about 12 new infections per year in Saint Georges and Oiapoque, representing an HIV incidence rate of 3.8 cases per 10,000 per year. HPV prevalence in Saint Georges ranges between 25 and 30% and between 35 and 40% in Camopi. Testing activity for other sexually transmitted infections markedly increased in the past 5 years; the introduction of PCR for chlamydiasis and gonorrhea also had a substantial impact on the number of diagnoses.ConclusionsThe ongoing cooperation between multiple partners on both sides of the border has led to remarkable progress in primary prevention, in testing efforts, in treatment and retention on both sides of the border. In a region with intense health professional turnover, nurturing cooperation and providing accurate assessments of the burden of sexually transmitted infections is essential to tackle a problem that is shared on both sides of the border.

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Section: Results Of the Review Of Available Information Hiv/aidsmentioning

confidence: 88%

Sexually transmitted infections on the border between Brazil and French Guiana

Divino

Leborgne

Correa³

et al. 2023

Front. Public Health

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“…While 29% of the total population and nearly half of adults are foreigners, for persons living with the Human Immunodeficiency Virus (HIV), 80% are foreigners ( 3 ). Although many immigrants with HIV come from HIV endemic countries, we have shown that over half acquire the infection early after arrival in French Guiana, presumably because of enhanced sexual vulnerability linked to social precariousness ( 4 , 5 ). In this context, the transmission mode of HIV is by far mostly heterosexual, with a balanced number of males and females.…”

Section: Introductionmentioning

confidence: 89%

Thirty years of HIV pregnancies in French Guiana: prevention successes and remaining obstetrical challenges

Nacher,

Blanc,

Rabier

et al. 2024

Front. Glob. Womens Health

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IntroductionIn a context of high HIV prevalence, poor pregnancy follow-up, frequent poverty, preeclampsia, and preterm delivery, we aimed to describe the characteristics and outcomes of pregnancies among women living with HIV in French Guiana.MethodsA retrospective cohort study was conducted on HIV-infected pregnancies enrolled between January 1st 1992 to 31st July 2022. Overall, there were 1,774 pregnancies in 881 women living with HIV.ResultsFor 75.1% of pregnancies, the HIV diagnosis was already known before pregnancy and in 67.6% of women, HIV follow-up predated pregnancy. Nearly half of women, 49.6%, only had one pregnancy since having been diagnosed with HIV. Although most women received antiretroviral therapy during pregnancy, for those with the available information we found only 48.5% had an undetectable viral load at delivery. Overall, 15.3% of pregnancies ended with an abortion. There were a total of 110 newborns infected with HIV representing an overall transmission rate of 6.2% (110/1,771). Between 1993 and 2002, the transmission rate was 34%, between 2003 and 2012 it was 1.3%, and between 2013 and 2022 it was 0.7%. Overall, in Cayenne, since 2008, 106 of 581 HIV–infected pregnancies (18.2%) with available information were premature before 37 weeks of pregnancy; of these, 33 (5.7%) were very preterm deliveries and 73 (13.3%) were late preterm deliveries. Over time, in Cayenne, preterm delivery declined significantly.ConclusionsThe present study emphasizes that, despite spectacular progress in reducing mother to child transmission, pregnancy outcomes among women living with HIV are still preoccupying with high incidence of preterm delivery and low birth weight. Teasing out what fraction is linked to HIV and what fraction is linked to social precariousness and poor follow-up was not possible in this study. Despite the high incidence of very preterm delivery recent progress suggests that coordination efforts to improve follow-up may also have improved obstetrical outcomes.

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“…Innovative research approaches which can be utilized to generate nuanced insights and inform targeted prevention strategies include phylogenetic and phylodynamic analysis of HIV sequences to study phylogenetic clustering in migrant communities, providing insights into when and where transmissions occurred, but so far, these efforts were mostly limited to labour migrants [82,83]. Rapid, portable and relatively cheap genetic sequencing technologies (i.e.…”

Section: Harnessing Momentum To Achieve Hiv Equitymentioning

confidence: 99%

Left behind on the path to 90‐90‐90: understanding and responding to HIV among displaced people

et al. 2022

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Introduction:In 2021, the number of people affected by displacement worldwide reached the highest on record, with an estimated 30.5 million refugees and 4.6 million asylum seekers seeking safety across international borders and further 53.2 million people displaced within their countries of origin. Most forcibly displaced persons come from or relocate to lower-and middle-income countries (LMICs) and many of those countries have large HIV epidemics. In this commentary, we describe some of the challenges at the intersection of HIV and displacement vulnerabilities that cannot be easily addressed in resourcelimited environments. Discussion: HIV transmission and prevention and treatment efforts in the context of displacement are affected by myriad behavioural, social and structural factors across different stages of the displacement journey. For example, structural barriers faced by people experiencing displacement in relation to HIV prevention and care include funding constraints and legal framework deficiencies. Such barriers prevent all forced migrants, and particularly those whose sexual identities or practices are stigmatized against, access to prevention and care equal to local residents. Xenophobia, racism and other social factors, as well as individual risky behaviours facilitated by experiences of forced migration, also affect the progress towards 90-90-90 targets in displaced populations. Current evidence suggests increased HIV vulnerability in the period before displacement due to the effect of displacement drivers on medical supplies and infrastructure. During and after displacement, substantial barriers to HIV testing exist, though following resettlement in stable displacement context, HIV incidence and viral suppression are reported to be similar to those of local populations. Conclusions: Experiences of often-marginalized displaced populations are diverse and depend on the context of displacement, countries of origin and resettlement, and the nature of the crises that forced these populations to move. To address current gaps in responses to HIV in displacement contexts, research in LMIC, particularly in less stable resettlement settings, needs to be scaled up. Furthermore, displaced populations need to be specifically addressed in national AIDS strategies and HIV surveillance systems. Finally, innovative technologies, such as point-of-care viral load and CD4 testing, need to be developed and introduced in settings facing displacement.

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Using phylogenetic surveillance and epidemiological data to understand the HIV-1 transmission dynamics in French Guiana

Cited by 10 publications

References 24 publications

Sexually transmitted infections on the border between Brazil and French Guiana

Sexually transmitted infections on the border between Brazil and French Guiana

Thirty years of HIV pregnancies in French Guiana: prevention successes and remaining obstetrical challenges

Left behind on the path to 90‐90‐90: understanding and responding to HIV among displaced people

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