Non-B subtypes account for a large proportion of clustered primary HIV-1 infections in Italy. (20th April 2022)

• Record Type: Journal Article
• Authors: Bozzi, Giorgio; Fabeni, Lavinia; Abbate, Isabella; Berno, Giulia; Muscatello, Antonio; Taramasso, Lucia; Fabbiani, Massimiliano; Nozza, Silvia; Tambussi, Giuseppe; Rusconi, Stefano; Giacomelli, Andrea; Focà, Emanuele; Pinnetti, Carmela; d'Ettorre, Gabriella; Mussini, Cristina; Borghi, Vanni; Celesia, Benedetto Maurizio; Madeddu, Giordano; Di Biagio, Antonio; Ripamonti, Diego; Squillace, Nicola; Antinori, Andrea; Gori, Andrea; Capobianchi, Maria Rosaria; Bandera, Alessandra
• Other Names: author non-byline.; Gori Andrea author non-byline.; Muscatello Antonio author non-byline.; Bandera Alessandra author non-byline.; Squillace Nicola author non-byline.; Tambussi Giuseppe author non-byline.; Nozza Silvia author non-byline.; Ripa Marco author non-byline.; Dell'Acqua Raffele author non-byline.; Bruzzesi Elena author non-byline.; Mastrangelo Andrea author non-byline.; Antinori Andrea author non-byline.; Pinnetti Carmela author non-byline.; Calcagno Andrea author non-byline.; Orofino Gianfranco author non-byline.; Benedetto Ilaria De author non-byline.; Ferrara Micol author non-byline.; Mussini Cristina author non-byline.; Borghi Vanni author non-byline.; Carli Federica author non-byline.; Celesia Benedetto Maurizio author non-byline.; Cosco Lucio author non-byline.; Torti Carlo author non-byline.; D'Ettorre Gabriella author non-byline.; Biagio Antonio Di author non-byline.; Taramasso Lucia author non-byline.; Focà Emanuele author non-byline.; Quiros-Roldan Eugenia author non-byline.; Franco Antonina author non-byline.; Ripamonti Diego author non-byline.; Maggiolo Franco author non-byline.; Gulminetti Roberto author non-byline.; Fabbiani Massimiliano author non-byline.; Piga Sandro author non-byline.; Garau Marzia author non-byline.; Campus Marco author non-byline.; Rusconi Stefano author non-byline.; Formenti Tiziana author non-byline.; Gabrieli Arianna author non-byline.; Lai Alessia author non-byline.; Bonazzetti Cecilia author non-byline.; Giacomelli Andrea author non-byline.; Marchetti Giulia author non-byline.; Tincati Camilla author non-byline.; Cingolani Antonella author non-byline.; Madeddu Giordano author non-byline.;
• Is Part Of: Sexually transmitted infections. Volume 99:issue 1(2023)
• Page Start: 53
• Page End: 56
• Publication Date: 2022-04-20
• Subjects: HIV -- MOLECULAR EPIDEMIOLOGY -- Disease Transmission, Infectious; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2021-055289
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Objectives and design: Using pol sequences obtained for routine resistance testing, we characterised the molecular patterns of HIV-1 transmission and factors associated with being part of a transmission cluster among individuals who in 2008–2014 presented with primary HIV-1 infection (PHI) at 11 urban centres across Italy. Methods: Pol sequences were obtained by Sanger sequencing. Transmission clusters were identified by phylogenetic analysis (maximum likelihood method, confirmed by Bayesian analysis). Multivariable logistic regression explored factors associated with a participant being part of a transmission cluster. Results: The PHI cohort comprised 186 participants (159/186, 85.5% males) with median age 44 years, median CD4 count 464 cells/mm 3 and median plasma HIV-1 RNA 5.6 log10 copies/mL. Drug resistance associated mutations were found in 16/186 (8.6%). A diversity of non-B subtypes accounted for 60/186 (32.3%) of all infections. A total of 17 transmission clusters were identified, including 44/186 (23.7%) participants. Each cluster comprised 2–6 sequences. Non-B subtypes accounted for seven clusters and 22/44 (50%) of clustered sequences. In multivariable logistic regression analysis, factors associated with being part of a transmission cluster comprised harbouring a non-B subtype (adjusted OR (adjOR) 2.28; 95% CI 1.03 to 5.05; p=0.04) and showing a lower plasma HIV-1 RNA (adjOR 0.80, 95% CI 0.64 to 0.99; p=0.04). Conclusions: There was a large contribution of diverse non-B subtypes to transmission clusters among people presenting with acute or recent HIV-1 infection in this cohort, illustrating the evolving dynamics of the HIV-1 epidemic in Italy, where subtype B previously dominated.