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Determinants of HIV-1 transmission clusters and transmitted drug resistance in men who have sex with men
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Resumo(s)
Introduction: In the EU/EEA, men who have sex with men (MSM) is a priority group for the prevention and control of HIV-1 infection. In Portugal, the 2023 HIV incidence rate was 8.2 per 100,000 inhabitants, with 876 new infections, 41.7% in MSM. We aim to characterize HIV-1 transmission clusters (TC) and transmitted drug resistance (TDR) and its sociodemographic, behavioral, clinical, and viral genomic determinants in MSM newly diagnosed in Portugal between 2014 and 2019. Methods: A total of 340 MSM newly diagnosed with HIV-1 infection at 17 hospitals in Portugal were included. TC was identified with branch support ≥90% and 1.5% genetic distance. Logistic regression models were used to examine factors associated with TC and TDR. Results: We identified 38 TC with 104 MSM, which includes 81 (26.6%) of the 305 MSM from our sample included in cluster analysis. The overall prevalence of TDR was 8.2%. Only HIV-1 subtype C was significantly associated with TDR. Overall, 10.5% of the clusters had at least 1 surveillance drug resistance mutation. There was no significant difference in the prevalence of TDR or the proportion of Portuguese and migrant MSM inside and outside clusters. Age at diagnosis, district of residence, unprotected sex with a woman, HIV testing, presenter status, and HIV-1 subtype were significantly associated with TC. Conclusion: Specific subgroups of MSM are contributing to HIV-1 clustered transmission in Portugal. However, no association was found between TDR and sociodemographic or behavioral factors. Directed prevention measures should focus on those subgroups.
Descrição
Funding Information: We would like to thank the participating PLWH and all the members of the Portuguese BEST HOPE Study Group. Funding Information: The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by European funds through the grant Bio-Molecular and Epidemiological Surveillance of HIV Transmitted Drug Resistance, Hepatitis Co-Infections and Ongoing Transmission Patterns in Europe (BEST HOPE) (project funded through HIVERA: Harmonizing Integrating Vitalizing European Research on HIV/ AIDS, grant no: 249697); by FCT for funds to GHTM-UID/ Multi/04413/2013, GHTM-UID/04413/2020 and LA-REAL - LA/P/0117/2020; by the MigrantHIV project (financed by FCT: PTDC/DTP-EPI/7066/2014); by Characterisation of drug-resistance TB and HIV, and associated sociobehavioral factors among migrants in Lisbon, Portugal project financed by GHTM-UID/ Multi/04413/2013; by Integriv project (financed by FCT: PTDC/ SAUINF/31990/2017) and the MARVEL project (financed by FCT: PTDC/SAU-PUB/4018/2021). This study was financed by the Gilead G\u00E9nese programme through funding to project HIVLatePresenters. Publisher Copyright: © 2025 The Author(s)
Palavras-chave
drug resistance HIV-1 Men who have sex with men Portugal Transmission cluster Microbiology (medical) Infectious Diseases SDG 3 - Good Health and Well-being