Molecular Epidemiology of the HIV Epidemic in Three German Metropolitan Regions – Cologne/Bonn, Munich and Hannover, 1999–2016

Abstract

Using HIV sequence data to characterize clusters of HIV transmission may provide insight into the epidemic. Phylogenetic and network analyses were performed to infer putative relationships between HIV-1 partial pol sequences from 2,774 individuals receiving care in three German regions between 1999–2016. The regions have in common that they host some of the largest annual festivals in Europe (Carnival and Oktoberfest). Putative links with sequences (n = 150,396) from the Los Alamos HIV Sequence database were evaluated. A total of 595/2,774 (21.4%) sequences linked with at least one other sequence, forming 184 transmission clusters. Clustering individuals were significantly more likely to be younger, male, and report sex with men as their main risk factor (p < 0.001 each). Most clusters (77.2%) consisted exclusively of men; 41 (28.9%) of these included men reporting sex with women. Thirty-two clusters (17.4%) contained sequences from more than one region; clustering men were significantly more likely to be in a position bridging regional HIV epidemics than clustering women (p = 0.027). We found 236 clusters linking 547 sequences from our sample with sequences from the Los Alamos database (n = 1407; 31% from other German centres). These results highlight the pitfalls of focusing HIV prevention efforts on specific risk groups or specific locales.

Dynamics of HIV-1 Molecular Networks Reveal Effective Control of Large Transmission Clusters in an Area Affected by an Epidemic of Multiple HIV Subtypes

“…The prevalence of CRF01_AE and subtype B decreased by around 20% (from 91.9 to 73.6%) between 2008 and 2016, whereas that of CRF07_BC and other CRFs or URFs increased. The few network studies that have been carried out in areas with multiple HIV subtypes and have typically used one single genetic threshold (Hoenigl et al, 2016a;Stecher et al, 2018). Rates of HIV-1 evolution vary across subtypes (Patino-Galindo and Gonzalez-Candelas, 2017;Bbosa et al, 2019a), and no previous studies have focused on HIV evolution or threshold selection for our local epidemic strains.…”

“…HIV molecular networks can be used not only to guide targeted intervention in key subpopulations (Aldous et al, 2012;Lubelchek et al, 2015;Castley et al, 2017;Chaillon et al, 2017;Zhang et al, 2017;Stecher et al, 2018;Volz et al, 2018;Ragonnet-Cronin et al, 2019;Board et al, 2020), but also to reconstruct the history of HIV spread between populations (Kouyos et al, 2010;Brenner et al, 2017;Pineda-Pena et al, 2018;Delgado et al, 2019;Fabeni et al, 2019). Several local and national studies conducted in recent years have monitored the dynamics of HIV molecular clusters and evaluated their expansion speed (Chan et al, 2015;Mehta et al, 2018;Ragonnet-Cronin et al, 2018;Wertheim et al, 2018;Jovanovic et al, 2019;Dennis et al, 2020).…”

Epidemiological analyses of regional and age differences of HIV/AIDS prevalence in China, 2004–2016

“…Moreover, sexual behaviors, condom use, male circumcision, antiretroviral therapy and sharing syringes among drug users all have different impacts on HIV/AIDS prevalence (Zhang et al, 2008;Nikolopoulos and Bonovas, 2017;Kelly et al 2017). A series of studies on HIV/AIDS prevalence in the United States (Rios-Gonzalez and Flores-Enriquez, 2018), China (Yuan et al, 2018;Yang et al, 2017;Lu et al, 2017;Tang et al, 2016;Pan et al, 2016), Africa (Scriven et al, 2016), Germany (Stecher et al, 2018) and Ukraine (Vasylyeva et al, 2018) have been published, but rare national studies were reported about the impacts of regional and age differences on clinical epidemiology of HIV/AIDS. Considerable changes of related policies have been provided including the implementation of innovative strategies and a comprehensive anti-HIV program over the last 20 years in China.…”

Predictors of Long-Term HIV Pre-exposure Prophylaxis Adherence After Study Participation in Men Who Have Sex With Men

“…Despite declining numbers of incident infections, HIV continues to have a disproportionate impact on men who have sex with men (MSM). [1][2][3] The efficacy of tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) for HIV pre-exposure prophylaxis (PrEP) in MSM has been well documented in several randomized controlled trials. [4][5][6] The effectiveness of TDF/FTC for HIV PrEP strongly depends on adherence.…”