{"id":41,"date":"2008-10-30T22:30:15","date_gmt":"2008-10-30T22:30:15","guid":{"rendered":"http:\/\/localhost\/new\/htb\/?p=41"},"modified":"2013-08-23T13:30:24","modified_gmt":"2013-08-23T13:30:24","slug":"recently-hiv-infected-quebec-residents-cause-more-than-half-of-new-cases","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/41","title":{"rendered":"Recently infected HIV-positive Quebec residents cause more than half of new cases"},"content":{"rendered":"<p><strong>Mark Mascolini for NATAP.org<\/strong><\/p>\n<p><strong>Most new HIV cases in Quebec, Canada, can be traced to recently infected but still untreated people in the province, according to an 859-person analysis<\/strong> [1]<strong>. The study traced genetic links among 56% of viruses from newly infected people, a slight increase from the clustering rate reported in a previous study by the same research group<\/strong> [2].<\/p>\n<p>Mark Wainberg (McGill University, Montreal) analysed HIV-1 pol gene sequences of subtype B virus from 859 people infected within 6 months of first viral sampling from 1998 through 2007. Comparing the sequences through phylogenetic analysis, he classified the viruses as unique, parts of small clusters (2 to 4 linked viruses), or parts of large cluster (5 or more linked viruses). The proportion of viruses that could be assigned to clusters rose from 49% in December 2005 to 56% in June 2007. Of course all HIV infections are linked to at least one other infection, but the source virus cannot always be identified.<\/p>\n<p>Of the 423 unique and small-cluster viruses identified before 2006, 403 (95%) represented dead-end viruses for which no further transmission could be identified. In contrast, viruses in 21 large clusters were parts of growing transmission cascades: The cluster rate grew from 6.6 to 10.3 viruses per cluster over the course of the study.<\/p>\n<p>Viruses carrying mutations that make HIV resistant to nucleosides were less frequent in large clusters (1.2%) than in small clusters (3.4%) or in unique viral samples (7.9%). In contrast, the nonnucleoside mutations K103N\/R and G190A were significantly more frequent in large clusters (12.1%) than in small clusters (3.3%) (P &lt; 0.0001).<\/p>\n<p>One immense cluster included 27 viruses harboring the G190A mutation, which made the viruses more than 50-fold resistant to nevirapine. But those viruses remained susceptible to efavirenz and were more than 10-fold hypersusceptible to etravirine (TMC125), the newest NNRTI.<\/p>\n<p>Wainberg concluded that in the population studied, most new HIV infections &#8220;arise from untreated persons at early stages of infection, often unaware of their serostatus.&#8221; He cautioned that newly infected people with a high viral load who are unaware of their HIV status pose a special risk of onward HIV transmission.<\/p>\n<p>Source:<br \/>\n<a href=\"http:\/\/www.natap.org\">http:\/\/www.natap.org<\/a><\/p>\n<p>References:<\/p>\n<ol>\n<li>Wainberg M, Brenner B, Roger M, Routy J, Moisi D. Impact of clustering on the transmission of HIV-1 variants harbouring drug resistance. 3rd International Workshop on HIV Transmission: Principles of Intervention. July 31-August 2, 2008, Mexico City. Abstract 36.<\/li>\n<li>Brenner BG, Roger M, Routy JP, et al. High rates of forward transmission events after acute\/early HIV-1 infection. J Infect Dis. 2007;195:951-959.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Mark Mascolini for NATAP.org Most new HIV cases in Quebec, Canada, can be traced to recently infected but still untreated people in the province, according to an 859-person analysis [1]. The study traced genetic links among 56% of viruses from &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,10],"tags":[117],"class_list":["post-41","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-transmission-and-prevention","tag-intl-transmission-workshop-3rd-2008"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/41","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=41"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/41\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=41"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=41"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=41"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}