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. 2023 Feb 1;37(2):299-303.
doi: 10.1097/QAD.0000000000003416. Epub 2022 Nov 18.

HIV transmission among acutely infected participants of a Dutch cohort study 2015-2021 is not associated with large, clustered outbreaks

Henrieke A B Prins  1 , Casper Rokx  1 , Annelies Verbon  1 , Ard van Sighem  2 , Godelieve J de Bree  3 , Maartje Dijkstra  3   4 , Jan M Prins  3 , Peter Reiss  2   3   5 , Jeroen J A van Kampen  6 , David A M C van de Vijver  6
Affiliations

HIV transmission among acutely infected participants of a Dutch cohort study 2015-2021 is not associated with large, clustered outbreaks

Henrieke A B Prins et al. AIDS. .

Abstract

Objective: Timely identification of acute or early HIV infection (AEHI) is important to help prevent onward transmission, and understanding the number of secondary infections resulting from individuals with AEHI is key to planning HIV prevention services and case finding.

Design: We performed a phylogenetic investigation of a dense sample of individuals with AEHI who took part in the Netherlands Cohort Study on Acute HIV infection (NOVA) in the Netherlands during 2015-2021.

Methods: Transmission clusters were identified using phylogenetic analyses based on HIV pol sequences. The Tamura-Nei model was used to estimate genetic distance. A number of 1000 bootstraps was used to check the reliability of clustering using maximum likelihood. A cluster was defined as having a bootstrap value of at least 95% and a genetic distance of at most 1.5%. Sensitivity analyses using different values for the bootstrap and genetic distance were performed to study the reproducibility of the clustering.

Results: Of the 156 participants included in NOVA between July 2015 and April 2021, 134 individuals for whom baseline characteristics and genotypic resistance data at baseline were available could be included. We identified 10 clusters, but the majority of persons (111/134) were not part of a cluster, suggesting mainly independent transmission events.

Conclusion: Mainly independent transmission events among a study population consisting predominantly of MSM in a low-incidence high-resource setting is likely the result of active AEHI case finding and direct start of treatment, and the roll-out over recent years of preventive measures such as preexposure prophylaxis.

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Conflict of interest statement

The following authors have received grants and honoraria: G.d.B. from Bristol-Meyer Squibbs, Gilead Sciences, ViiV Healthcare, Exevir, Aidsfonds and Takeda, all paid through institution; P.R. from Gilead Sciences, Janssen Pharmaceutica, ViiV Healthcare and Merck, Gilead Sciences, all paid to his institution; C.R. from AIDSfonds, ZonMW, Dutch Federation Medical Specialists, Health Holland, Merck, Janssen-Cilag, Gilead and ViiV Healthcare; J.v.K from NIH, ZonMW, Health Holland, and Aidsfonds. All other authors declared no conflicts of interest.

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