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
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 <i>pol</i...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/14/9/1895 |
| _version_ | 1797481424273539072 |
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| author | Bin Zhao Yu Qiu Wei Song Mingming Kang Xue Dong Xin Li Lu Wang Jianmin Liu Haibo Ding Zhenxing Chu Lin Wang Wen Tian Hong Shang Xiaoxu Han |
| author_facet | Bin Zhao Yu Qiu Wei Song Mingming Kang Xue Dong Xin Li Lu Wang Jianmin Liu Haibo Ding Zhenxing Chu Lin Wang Wen Tian Hong Shang Xiaoxu Han |
| author_sort | Bin Zhao |
| collection | DOAJ |
| description | 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 <i>pol</i> 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 (<i>p</i> < 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 (<i>p</i> < 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 (<i>p</i> < 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. |
| first_indexed | 2024-03-09T22:14:22Z |
| format | Article |
| id | doaj.art-808e5fd178aa457da4b2b05ede5c0033 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-09T22:14:22Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-808e5fd178aa457da4b2b05ede5c00332023-11-23T19:25:58ZengMDPI AGViruses1999-49152022-08-01149189510.3390/v14091895Undiagnosed HIV Infections May Drive HIV Transmission in the Era of “Treat All”: A Deep-Sampling Molecular Network Study in Northeast China during 2016 to 2019Bin Zhao0Yu Qiu1Wei Song2Mingming Kang3Xue Dong4Xin Li5Lu Wang6Jianmin Liu7Haibo Ding8Zhenxing Chu9Lin Wang10Wen Tian11Hong Shang12Xiaoxu Han13NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaNHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaDepartment of Food Safety and Nutrition, Shenyang Center for Health Service and Administrative Law Enforcement (Shenyang Center for Disease Control and Prevention), Shenyang 110031, ChinaNHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaDepartment of Food Safety and Nutrition, Shenyang Center for Health Service and Administrative Law Enforcement (Shenyang Center for Disease Control and Prevention), Shenyang 110031, ChinaDepartment of Food Safety and Nutrition, Shenyang Center for Health Service and Administrative Law Enforcement (Shenyang Center for Disease Control and Prevention), Shenyang 110031, ChinaDepartment of Food Safety and Nutrition, Shenyang Center for Health Service and Administrative Law Enforcement (Shenyang Center for Disease Control and Prevention), Shenyang 110031, ChinaDepartment of Food Safety and Nutrition, Shenyang Center for Health Service and Administrative Law Enforcement (Shenyang Center for Disease Control and Prevention), Shenyang 110031, ChinaNHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaNHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaNHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaNHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaNHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaNHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, ChinaUniversal 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 <i>pol</i> 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 (<i>p</i> < 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 (<i>p</i> < 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 (<i>p</i> < 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.https://www.mdpi.com/1999-4915/14/9/1895HIVtreat allmolecular networkdriving factor |
| spellingShingle | Bin Zhao Yu Qiu Wei Song Mingming Kang Xue Dong Xin Li Lu Wang Jianmin Liu Haibo Ding Zhenxing Chu Lin Wang Wen Tian Hong Shang Xiaoxu Han 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 Viruses HIV treat all molecular network driving factor |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | HIV treat all molecular network driving factor |
| url | https://www.mdpi.com/1999-4915/14/9/1895 |
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