Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar;34(3):261-268.
doi: 10.1089/AID.2017.0076. Epub 2018 Jan 17.

A Cohort Approach to Real-Time Detection of Acute HIV Infections Among People Who Inject Drugs in St. Petersburg, Russia

Olga V Toussova  1 , Andrei P Kozlov  2   3 , Sergei V Verevochkin  2   3 , Kathryn E Lancaster  4 , Alla V Shaboltas  5 , Alexei Masharsky  5 , Elena Dukhovlinova  2   6 , William C Miller  4 , Irving F Hoffman  4
Affiliations

A Cohort Approach to Real-Time Detection of Acute HIV Infections Among People Who Inject Drugs in St. Petersburg, Russia

Olga V Toussova et al. AIDS Res Hum Retroviruses. 2018 Mar.

Abstract

To detect acute HIV infections (AHIs) in real time among people who inject drugs (PWID) in St. Petersburg, Russia and to test the feasibility of this approach. Prospective cohort study. One hundred seronegative or acutely HIV-infected at screening PWID were enrolled and followed until the end of the 12-month pilot period. Each participant was evaluated, tested, and counseled for HIV monthly. Two HIV tests were used: HIV antibody and HIV RNA PCR. If diagnosed with AHI, participants were followed weekly for a month; then, monthly for 3 months; and then, quarterly for the duration of the follow-up period. HIV risk behavior was assessed at each study visit. Most enrolled PWID were 30-39 years old, male, completed high school or more, not employed full-time, heroin users, and frequently shared injection paraphernalia. AHI prevalence at screening was 1.8% [95% confidence interval (CI): 0.4, 5.5]. Three participants with AHI at enrollment represented 3% (95% CI: 0.6, 8.5) of the 100 participants who consented to enroll. Among the HIV-uninfected participants (n = 97), the AHI incidence over time was 9.3 per 100 person-years. Persons with AHI were more likely to report alcohol intoxication within the prior 30 days. This was the first study to detect AHI using a cohort approach. The approach proved to be feasible: recruitment, retention, AHI detection, and virological endpoints were successfully reached. A cost analysis in a real-world setting would be required to determine if this strategy could be brought to scale. The study revealed continued high HIV incidence rate among PWID in St. Petersburg, Russia and the importance of prevention and treatment programs for this group.

Keywords: PWID cohort; Russia; acute HIV incidence.

PubMed Disclaimer

Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Participant eligibility, follow up, and AHI testing. AHI, acute HIV infection.
<b>FIG. 2.</b>
FIG. 2.
Median (IQR) viral load progression for first 4 weeks among person with AHI. IQR, interquartile range.
See this image and copyright information in PMC

References

    1. HIV in Russian Federation in 2015 (in Russian): Available at www.hivrussia.ru, accessed on June7, 2016
    1. Dukhovlinova EV, Masharsky AE, Toussova OV, et al. : Two independent HIV epidemics in Saint Petersburg, Russia revealed by molecular epidemiology. AIDS Res Hum Retroviruses 2015;31:608–614 - PMC - PubMed
    1. Shaboltas AV, Toussova OV, Hoffman IF, et al. : HIV prevalence, sociodemographic, and behavioral correlates and recruitment methods among injection drug users in St. Petersburg, Russia. J Acquir Immune Defic Syndr 2006;41:657–663 - PubMed
    1. Gyarmathy VA, Li N, Tobin KE, Hoffman IF, et al. : Correlates of unsafe equipment sharing among injecting drug users in St. Petersburg, Russia. Eur Addict Res 2009;15:163–170 - PMC - PubMed
    1. Niccolai LM, Toussova OV, Verevochkin SV, Barbour R, Heimer R, Kozlov AP: High HIV prevalence, suboptimal HIV testing, and low knowledge of HIV-positive serostatus among injection drug users in St. Petersburg, Russia. AIDS Behav 2010;14:932–934 - PMC - PubMed

Publication types

LinkOut - more resources