EQUIP-MatCH, Pétion-Ville, Haiti; and.
Division of Infectious Diseases, University of California San Diego, San Diego, CA.
J Acquir Immune Defic Syndr. 2020 Dec 1;85(4):416-422. doi: 10.1097/QAI.0000000000002475.
In low HIV prevalence settings, understanding the transmission dynamics and the impact of drug resistance is critical to curb down the epidemic. This study aims to explore the prevalence and dynamics of transmission of HIV drug-resistance mutations (DRMs) among key populations in Haiti.
Eligible participants (naive, treated) were selected from 7 key population friendly health care centers in Port-au-Prince, Haiti, from September 2018 to July 2019.
A total of 119 HIV-1 pol sequences were analyzed from men having sex with men (MSM), female sex workers (FSWs), and their sexual partners. Screening for HIV DRMs was performed using the Stanford University Drug Resistance Database. Phylogenetic and network analyses using HIV-TRACE software were performed to infer putative relationships and shared DRMs.
Of the 119 participants, 62.2% were men (74/119), and 75.7% of them (56/74) reported MSM as a main risk factor. The overall DRM prevalence was 58.8% (70/119). A DRM was observed in 37.5% of MSM (21/56), 82.2% of FSWs (37/45), and 66.7% (12/18) among FSWs' clients. In a multivariate model, age and FSWs were significant predictors for DRMs (P = 0.001). Transmission network analysis found 24 of the 119 (20.2%) genetically linked individuals forming 8 clusters. Clustering participants were mostly MSM (15/24; 62.5%). Five clusters (62.5%) had shared DRMs, and K103N and M184V were the main shared mutations.
High prevalence of HIV DRMs was observed among MSM, FSWs, and their clients in Port-au-Prince, Haiti. Network analysis revealed frequent DRM transmission among genetically linked individuals, highlighting the need for appropriate interventions to limit HIV transmission in these high-risk populations.
在 HIV 低流行地区，了解传播动态和耐药性的影响对于遏制疫情至关重要。本研究旨在探索海地重点人群中 HIV 耐药突变（DRMs）的流行和传播动态。
2018 年 9 月至 2019 年 7 月，从海地太子港的 7 个重点人群友好型医疗保健中心选择符合条件的参与者（初治、治疗）。
对 119 名男男性行为者（MSM）、女性性工作者（FSW）及其性伴侣的 HIV-1 pol 序列进行分析。使用斯坦福大学耐药数据库进行 HIV 耐药筛查。使用 HIV-TRACE 软件进行系统发生和网络分析，以推断可能的关系和共享耐药突变。
在 119 名参与者中，62.2%为男性（74/119），其中 75.7%（56/74）报告 MSM 为主要风险因素。总的 DRM 流行率为 58.8%（70/119）。MSM 中观察到 37.5%（21/56）、FSW 中 82.2%（37/45）和 FSW 客户中 66.7%（12/18）存在 DRM。在多变量模型中，年龄和 FSW 是 DRM 的显著预测因素（P = 0.001）。传播网络分析发现 119 人中的 24 人（20.2%）具有遗传关联，形成 8 个簇。聚类参与者主要为 MSM（15/24；62.5%）。有 5 个簇（62.5%）具有共享的 DRM，主要的共享突变为 K103N 和 M184V。
在海地太子港，MSM、FSW 和他们的客户中观察到 HIV 耐药突变的高流行率。网络分析显示，遗传相关个体之间频繁发生 DRM 传播，这突出表明需要采取适当的干预措施，以限制这些高危人群中的 HIV 传播。
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