Phylogenetic evidence for underreporting of male‐to‐male sex among human immunodeficiency virus–infected donors in the Netherlands and Flanders

Laar, Thijs J. van de; Bezemer, Daniela; Laethem, Kristel Van; Vandewalle, Giovani; Smet, Annie de; Wijngaerden, Eric Van; Claas, Eric C. J.; Sighem, A.I. van; Vandamme, Anne‐Mieke; Compernolle, Veerle; Zaaijer, Hans L.

doi:10.1111/trf.14097

Cited by 13 publications

(9 citation statements)

References 36 publications

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“…Noteworthy was that the majority of MTCs found the number of MSM clearly outweighed the number of heterosexuals, and in many, only men were represented. This observation is in line with that reported in previous studies and suggests that misreporting of transmission risk may be an important reason for the presence of mixed clusters [ 10 , 37 , 38 ]. The most important reason for misreporting could be fear or embarrassment to disclose sex with same-gender sex.…”

Section: Discussionsupporting

confidence: 93%

Evaluation of HIV Transmission Clusters among Natives and Foreigners Living in Italy

Fabeni

Santoro

Lorenzini

et al. 2020

Viruses

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We aimed at evaluating the characteristics of HIV-1 molecular transmission clusters (MTCs) among natives and migrants living in Italy, diagnosed between 1998 and 2018. Phylogenetic analyses were performed on HIV-1 polymerase (pol) sequences to characterise subtypes and identify MTCs, divided into small (SMTCs, 2–3 sequences), medium (MMTCs, 4–9 sequences) and large (LMTCs, ≥10 sequences). Among 3499 drug-naïve individuals enrolled in the Italian Cohort Naive Antiretroviral (ICONA) cohort (2804 natives; 695 migrants), 726 (20.8%; 644 natives, 82 migrants) were involved in 228 MTCs (6 LMTCs, 36 MMTCs, 186 SMTCs). Migrants contributed 14.4% to SMTCs, 7.6% to MMTCs and 7.1% to LMTCs, respectively. HIV-1 non-B subtypes were found in 51 MTCs; noteworthy was that non-B infections involved in MTCs were more commonly found in natives (n = 47) than in migrants (n = 4). Factors such as Italian origin, being men who have sex with men (MSM), younger age, more recent diagnosis and a higher CD4 count were significantly associated with MTCs. Our findings show that HIV-1 clustering transmission among newly diagnosed individuals living in Italy is prevalently driven by natives, mainly MSM, with a more recent diagnosis and frequently infected with HIV-1 non-B subtypes. These results can contribute to monitoring of the HIV epidemic and guiding the public health response to prevent new HIV infections.

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Section: Discussionsupporting

confidence: 93%

Evaluation of HIV Transmission Clusters among Natives and Foreigners Living in Italy

Fabeni

Santoro

Lorenzini

et al. 2020

Viruses

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“…However, TC6 encompassed sequences isolated in several countries, indicating a larger geographical spread. The disparity seen in TC5, composed only by males but mainly reporting heterosexual transmission route can be explained by the previously described MSM under-reporting 49,50 . Furthermore, “missing-links” can still exist, related to unavailable data that could help explain this disparity.…”

Section: Discussionmentioning

confidence: 92%

Characterization of a large cluster of HIV-1 A1 infections detected in Portugal and connected to several Western European countries

Araújo

Carvalho

Pingarilho

et al. 2019

Sci Rep

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HIV-1 subtypes associate with differences in transmission and disease progression. Thus, the existence of geographic hotspots of subtype diversity deepens the complexity of HIV-1/AIDS control. The already high subtype diversity in Portugal seems to be increasing due to infections with sub-subtype A1 virus. We performed phylogenetic analysis of 65 A1 sequences newly obtained from 14 Portuguese hospitals and 425 closely related database sequences. 80% of the A1 Portuguese isolates gathered in a main phylogenetic clade (MA1). Six transmission clusters were identified in MA1, encompassing isolates from Portugal, Spain, France, and United Kingdom. The most common transmission route identified was men who have sex with men. The origin of the MA1 was linked to Greece, with the first introduction to Portugal dating back to 1996 (95% HPD: 1993.6–1999.2). Individuals infected with MA1 virus revealed lower viral loads and higher CD4 + T-cell counts in comparison with those infected by subtype B. The expanding A1 clusters in Portugal are connected to other European countries and share a recent common ancestor with the Greek A1 outbreak. The recent expansion of this HIV-1 subtype might be related to a slower disease progression leading to a population level delay in its diagnostic.

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“…Second, we showed that clustering was associated with younger donors, with a recent infection, and infected with HIV-1 subtype B, which are characteristics more likely associated to the HIV+ MSM population in France. 17,31 Our results showed that 34.3% of MSM male BDs on a declaration basis were part of robust MSM clusters. This is exactly the same figure as found for MSM individuals in PRIMO.…”

Section: Discussionmentioning

confidence: 65%

HIV transmission network analysis allows identifying unreported risk factors in HIV‐positive blood donors in France

et al. 2021

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Objectives As sex between men is a major route of human immunodeficiency virus (HIV) infection in most western countries, restrictive deferral rules for blood donation have largely been implemented regarding men having sex with men (MSM). Here, we sought here to assign unreported HIV risk factors in blood donors (BDs) and reevaluated the MSM‐associated fraction of HIV transfusion residual risk (%RRMSM). Methods We applied a genetic distance‐based approach to infer an HIV transmission network for 384 HIV sequences from French BDs and 1337 HIV sequences from individuals with known risk factors (ANRS PRIMO primary HIV infection cohort). We validated the possibility of assigning a risk factor according to clustering using assortative mixing. Finally, we recalculated the %RRMSM. Results A total of 81 of 284 (28.5%) male and 5 of 100 (5%) female BDs belonged to a cluster; 72 (88.9%) of the 81 male BDs belonged to MSM clusters. After cluster correction, 8 of 67 (11.9%), 4 of 21 (19.0%), and 19 of 88 (21.6%) HIV‐positive (HIV+) male BDs with heterosexual, other, or unknown risk factors could be reclassified as MSM, accounting for 10.9% of the total HIV+ male BDs. Overall, 139 of 284 HIV+ male donors (48.9%) could be considered MSM between 2000 and 2016 in France. Between 2005 and 2016, the %RRMSM increase varied from 0 to 19%, without differing significantly from the %RRMSM before reclassification. Conclusion Network inference can be used to complement declaration data on risk factors for HIV infection in BDs. This approach, complementary to behavioral studies, is a valuable tool to evaluate the effect of changes in deferral criteria on BD compliance.

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Phylogenetic evidence for underreporting of male‐to‐male sex among human immunodeficiency virus–infected donors in the Netherlands and Flanders

Cited by 13 publications

References 36 publications

Evaluation of HIV Transmission Clusters among Natives and Foreigners Living in Italy

Evaluation of HIV Transmission Clusters among Natives and Foreigners Living in Italy

Characterization of a large cluster of HIV-1 A1 infections detected in Portugal and connected to several Western European countries

HIV transmission network analysis allows identifying unreported risk factors in HIV‐positive blood donors in France

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