Undiagnosed HIV Infections May Drive HIV Transmission in the Era of "Treat All": A Deep-Sampling Molecular Network Study in Northeast China during 2016 to 2019

被引：5

作者：

Zhao, Bin ^{[1
,2
,3
,4
]}

Qiu, Yu ^{[1
,2
,3
,4
]}

Song, Wei ^{[5
]}

Kang, Mingming ^{[1
,2
,4
]}

Dong, Xue ^{[5
]}

Li, Xin ^{[5
]}

Wang, Lu ^{[5
]}

Liu, Jianmin ^{[5
]}

Ding, Haibo ^{[1
,2
,3
,4
]}

Chu, Zhenxing ^{[1
,2
,3
,4
]}

Wang, Lin ^{[1
,2
,3
,4
]}

Tian, Wen ^{[1
,2
,3
,4
]}

Shang, Hong ^{[1
,2
,3
,4
]}

Han, Xiaoxu ^{[1
,2
,3
,4
]}

机构：

[1] China Med Univ, NHC Key Lab AIDS Immunol, Natl Clin Res Ctr Lab Med, Hosp 1, Shenyang 110001, Peoples R China

[2] Chinese Acad Med Sci, Lab Med Innovat Unit, Shenyang 110001, Peoples R China

[3] Key Lab AIDS Immunol Liaoning Prov, Shenyang 110001, Peoples R China

[4] Collaborat Innovat Ctr Diag & Treatment Infect Di, 79 Qingchun St, Hangzhou 310003, Peoples R China

[5] Shenyang Ctr Dis Control & Prevent, Dept Food Safety & Nutr, Shenyang Ctr Hlth Serv & Adm Law Enforcement, Shenyang 110031, Peoples R China

来源：

VIRUSES-BASEL | 2022年 / 14卷 / 09期

关键词：

HIV; treat all; molecular network; driving factor; IMMUNODEFICIENCY-VIRUS TRANSMISSION; DRUG-RESISTANCE; MEN; SEX; EPIDEMIC;

D O I：

10.3390/v14091895

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Universal antiretroviral therapy (ART, "treat all") was recommended by the World Health Organization in 2015; however, HIV-1 transmission is still ongoing. This study characterizes the drivers of HIV transmission in the "treat all" era. Demographic and clinical information and HIV pol gene were collected from all newly diagnosed cases in Shenyang, the largest city in Northeast China, during 2016 to 2019. Molecular networks were constructed based on genetic distance and logistic regression analysis was used to assess potential transmission source characteristics. The cumulative ART coverage in Shenyang increased significantly from 77.0% (485/630) in 2016 to 93.0% (2598/2794) in 2019 (p < 0.001). Molecular networks showed that recent HIV infections linked to untreated individuals decreased from 61.6% in 2017 to 28.9% in 2019, while linking to individuals with viral suppression (VS) increased from 9.0% to 49.0% during the same time frame (p < 0.001). Undiagnosed people living with HIV (PLWH) hidden behind the links between index cases and individuals with VS were likely to be male, younger than 25 years of age, with Manchu nationality (p < 0.05). HIV transmission has declined significantly in the era of "treat all". Undiagnosed PLWH may drive HIV transmission and should be the target for early detection and intervention.

引用

页数：11