In a study published by the National Library of Medicine, it was found that rapid diagnosis of HIV is crucial for halting transmission from acutely infected individuals.
In the world of HIV prevention, identifying and understanding acute or early HIV infection (AEHI) is crucial for interrupting transmission chains. Knowledge about secondary infections resulting from individuals with AEHI is pivotal for planning effective HIV prevention services and case identification strategies.
This study, published in the journal AIDS, delves into the transmission dynamics of AEHI cases among participants in the Netherlands Cohort Study on Acute HIV Infection (NOVA), conducted between 2015 and 2021.
Investigative Methods Used
A phylogenetic investigation was carried out on a dense sample of individuals with AEHI from the NOVA study. The analysis was based on HIV pol sequences, and the Tamura-Nei model was utilized to estimate genetic distances. Transmission clusters were defined with a bootstrap value of at least 95% and a genetic distance of at most 1.5%. Sensitivity analyses were conducted with varying bootstrap and genetic distance values to determine the reproducibility of clustering results.
Independent Transmission Dominates
Out of the 156 participants enrolled in NOVA between July 2015 and April 2021, 134 individuals with baseline characteristics and genotypic resistance data available at baseline were included in the study. The analysis revealed the presence of 10 distinct clusters; however, a significant majority (111 out of 134) were not part of any cluster. This suggests that the transmission events primarily occurred independently rather than in large, interconnected outbreaks.
Conclusion
The absence of large, clustered outbreaks among individuals with AEHI in this study population, predominantly consisting of men who have sex with men (MSM) in a low-incidence, high-resource setting, highlights the efficacy of active AEHI case identification and immediate treatment initiation. The implementation of preventive measures such as pre-exposure prophylaxis (PrEP) over recent years has likely contributed to the reduction in interconnected transmissions. These findings underscore the importance of targeted interventions and ongoing efforts in early detection and treatment initiation to curb HIV transmission in similar populations.
This study illuminates the transmission patterns of AEHI cases within a Dutch cohort, emphasizing the role of proactive case identification, prompt treatment initiation, and preventive measures in preventing large-scale HIV outbreaks. Continued vigilance and strategic interventions remain essential in the fight against HIV transmission, particularly in populations with similar demographics and risk factors.
Source:
Prins, H., Rokx, C., Verbon, A., Van Sighem, A., De Bree, G. J., Dijkstra, M., Prins, J. M., Reiss, P., Van Kampen, J. J., & Van De Vijver, D. (2022). HIV transmission among acutely infected participants of a Dutch cohort study 2015–2021 is not associated with large, clustered outbreaks. AIDS, 37(2), 299–303. https://doi.org/10.1097/qad.0000000000003416
