Profiling the HIV epidemic with recency of infection instead of recency of diagnosis: 2 years of experience in North Carolina, USA.

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Date: Jan. 2021
Publisher: John Wiley & Sons, Inc.
Document Type: Report; Author abstract
Length: 483 words
Lexile Measure: 200L

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Abstract :

Background: The identification of recent (incident) HIV infections among people who are initially diagnosed for the first time is critical to HIV prevention. We developed a Multiplexed Primer ID-Next Gen Sequencing (MPID-NGS) approach to identify recent infection by measuring the intra-host viral diversity over multiple regions of the HIV genome. We examined the field implementations of MPID-NGS to identify recent infection and drug resistance mutations (DRMs) among persons with new HIV diagnoses reported by the North Carolina State Laboratory of Public Health in 2018 and 2019. Methods: The MPID-NGS libraries were constructed for protease (PR), partial reverse transcriptase (RT), integrase (IN), and the V1 to V3 region of the env gene using remnant serological diagnostic tests. New diagnoses were restricted to sera collected within 30 days of HIV diagnosis dates. The MiSeq platform was used for sequencing. The TCS-DR pipeline was used for bioinformatics analysis and to identify DRMs. Recent infection was defined as infection Results: A total of 515 persons with new diagnoses from 2018 to 2019 were successfully sequenced. Overall, 202 (39%) had recent infection, 241 (47%) were chronically infected, and 72 (14%) had indeterminate recency at time of diagnosis. We detected a greater percentage of recent infections in 2019 than 2018 (44% vs. 35%, p = 0.06). By comparing the characteristics of recent versus chronic infection at diagnosis, we found that young people were more likely to be diagnosed in the recent infection stage (p Conclusions: We demonstrate an all-in-one platform to monitor HIV-1 recency, DRMs, and phylogenetically linked transmission clusters in near real-time. We believe this approach has the potential to be a useful tool as part of public health efforts to reduce new infections by monitoring the percentage of recency among new HIV diagnoses and providing opportunity to interrupt transmission within clusters.

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Gale Document Number: GALE|A656303495