TY - JOUR
T1 - Earlier initiation of antiretroviral treatment coincides with an initial control of the HIV-1 sub-subtype F1 outbreak among men-having-sex-with-men in Flanders, Belgium
AU - Vinken, Lore
AU - Fransen, Katrien
AU - Cuypers, Lize
AU - Alexiev, Ivailo
AU - Balotta, Claudia
AU - Debaisieux, Laurent
AU - Seguin-Devaux, Carole
AU - Ribas, Sergio García
AU - Gomes, Perpétua
AU - Incardona, Francesca
AU - Kaiser, Rolf
AU - Ruelle, Jean
AU - Sayan, Murat
AU - Paraschiv, Simona
AU - Paredes, Roger
AU - Peeters, Martine
AU - Sönnerborg, Anders
AU - Vancutsem, Ellen
AU - Vandamme, Anne Mieke
AU - Van den Wijngaert, Sigi
AU - Van Ranst, Marc
AU - Verhofstede, Chris
AU - Stadler, Tanja
AU - Lemey, Philippe
AU - Van Laethem, Kristel
N1 - Funding Information:
This work was supported in part by grants from the Fonds voor Wetenschappelijk Onderzoek Vlaanderen (FWO) (G.0692.14N, G.0E84.16N, G.0B23.17N) and KU Leuven (Program Financing No. PF/10/018), and by the AIDS Reference Laboratories that receive support from the Belgian Ministry of Social Affairs through a fund within the Health Insurance System. The computational resources and services used in this work were partly provided by the Hercules Foundation and the Flemish Government – department EWI-FWO Krediet aan Navorsers (KAN2012 1.5.249.12). PL acknowledges funding from the European Research Council under the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement no. 725422-ReservoirDOCS), from the Special Research Fund, KU Leuven (“Bijzonder Onderzoeksfonds,” KU Leuven, OT/14/115), and the Research Foundation – Flanders (“Fonds voor Wetenschappelijk Onderzoek – Vlaanderen,” G.0662.15N, G.0D51.17N, and G.0B93.17N). TS was supported in part by the European Research Council under the 7th Framework Program of the European Commission (PhyPD, Grant Agreement 335529).
Funding Information:
This work was supported in part by grants from the Fonds voor Wetenschappelijk Onderzoek Vlaanderen (FWO) (G.0692.14N, G.0E84.16N, G.0B23.17N) and KU Leuven (Program Financing No. PF/10/018), and by the AIDS Reference Laboratories that receive support from the Belgian Ministry of Social Affairs through a fund within the Health Insurance System. The computational resources and services used in this work were partly provided by the Hercules Foundation and the Flemish Government – department EWI-FWO Krediet aan Navorsers (KAN2012 1.5.249.12). PL acknowledges funding from the European Research Council under the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement no. 725422-ReservoirDOCS), from the Special Research Fund, KU Leuven (“Bijzonder Onderzoeksfonds,” KU Leuven, OT/14/115), and the Research Foundation – Flanders (“Fonds voor Wetenschappelijk Onderzoek – Vlaanderen,” G.0662.15N, G.0D51.17N, and G.0B93.17N). TS was supported in part by the European Research Council under the 7th Framework Program of the European Commission (PhyPD, Grant Agreement 335529). This study was the result of a collaborative effort. We would like to thank Andrea-Clemencia Pineda-Peña, Yoeri Schrooten, Fossie Ferreira, and Tim Dierickx for their technical assistance, and the patients and clinicians at the AIDS Reference Centers who contributed data. We would like to acknowledge BREACH that facilitates HIV research among different actors in Belgium.
Publisher Copyright:
Copyright © 2019 Vinken, Fransen, Cuypers, Alexiev, Balotta, Debaisieux, Seguin-Devaux, García Ribas, Gomes, Incardona, Kaiser, Ruelle, Sayan, Paraschiv, Paredes, Peeters, Sönnerborg, Vancutsem, Vandamme, Van den Wijngaert, Van Ranst, Verhofstede, Stadler, Lemey and Van Laethem.
PY - 2019/3
Y1 - 2019/3
N2 - Human immunodeficiency virus type 1 (HIV-1) non-B subtype infections occurred in Belgium since the 1980s, mainly amongst migrants and heterosexuals, whereas subtype B predominated in men-having-sex-with-men (MSM). In the last decade, the diagnosis of F1 sub-subtype in particular has increased substantially, which prompted us to perform a detailed reconstruction of its epidemiological history. To this purpose, the Belgian AIDS Reference Laboratories collected HIV-1 pol sequences from all sub-subtype F1-infected patients for whom genotypic drug resistance testing was requested as part of routine clinical follow-up. This data was complemented with HIV-1 pol sequences from countries with a high burden of F1 infections or a potential role in the global origin of sub-subtype F1. The molecular epidemiology of the Belgian subtype F1 epidemic was investigated using Bayesian phylogenetic inference and transmission dynamics were characterized based on birth-death models. F1 sequences were retained from 297 patients diagnosed and linked to care in Belgium between 1988 and 2015. Phylogenetic inference indicated that among the 297 Belgian F1 sequences, 191 belonged to a monophyletic group that mainly contained sequences from people likely infected in Belgium (OR 26.67, 95% CI 9.59–74.15), diagnosed in Flanders (OR 7.28, 95% CI 4.23–12.53), diagnosed at a recent stage of infection (OR 7.19, 95% CI 2.88-17.95) or declared to be MSM (OR 34.8, 95% CI 16.0–75.6). Together with a Spanish clade, this Belgian clade was embedded in the genetic diversity of Brazilian subtype F1 strains and most probably emerged after one or only a few migration events from Brazil to the European continent before 2002. The origin of the Belgian outbreak was dated back to 2002 (95% higher posterior density 2000–2004) and birth-death models suggested that its extensive growth had been controlled (Re < 1) by 2012, coinciding with a time period where delay in antiretroviral treatment initiation substantially declined. In conclusion, phylogenetic reconstruction of the Belgian HIV-1 sub-subtype F1 epidemic illustrates the introduction and substantial dissemination of viral strains in a geographically restricted risk group that was most likely controlled by effective treatment as prevention.
AB - Human immunodeficiency virus type 1 (HIV-1) non-B subtype infections occurred in Belgium since the 1980s, mainly amongst migrants and heterosexuals, whereas subtype B predominated in men-having-sex-with-men (MSM). In the last decade, the diagnosis of F1 sub-subtype in particular has increased substantially, which prompted us to perform a detailed reconstruction of its epidemiological history. To this purpose, the Belgian AIDS Reference Laboratories collected HIV-1 pol sequences from all sub-subtype F1-infected patients for whom genotypic drug resistance testing was requested as part of routine clinical follow-up. This data was complemented with HIV-1 pol sequences from countries with a high burden of F1 infections or a potential role in the global origin of sub-subtype F1. The molecular epidemiology of the Belgian subtype F1 epidemic was investigated using Bayesian phylogenetic inference and transmission dynamics were characterized based on birth-death models. F1 sequences were retained from 297 patients diagnosed and linked to care in Belgium between 1988 and 2015. Phylogenetic inference indicated that among the 297 Belgian F1 sequences, 191 belonged to a monophyletic group that mainly contained sequences from people likely infected in Belgium (OR 26.67, 95% CI 9.59–74.15), diagnosed in Flanders (OR 7.28, 95% CI 4.23–12.53), diagnosed at a recent stage of infection (OR 7.19, 95% CI 2.88-17.95) or declared to be MSM (OR 34.8, 95% CI 16.0–75.6). Together with a Spanish clade, this Belgian clade was embedded in the genetic diversity of Brazilian subtype F1 strains and most probably emerged after one or only a few migration events from Brazil to the European continent before 2002. The origin of the Belgian outbreak was dated back to 2002 (95% higher posterior density 2000–2004) and birth-death models suggested that its extensive growth had been controlled (Re < 1) by 2012, coinciding with a time period where delay in antiretroviral treatment initiation substantially declined. In conclusion, phylogenetic reconstruction of the Belgian HIV-1 sub-subtype F1 epidemic illustrates the introduction and substantial dissemination of viral strains in a geographically restricted risk group that was most likely controlled by effective treatment as prevention.
KW - Belgium
KW - HIV-1
KW - Men-having-sex-with-men
KW - Phylodynamics
KW - Sub-subtype F1
KW - Treatment as prevention
UR - http://www.scopus.com/inward/record.url?scp=85065149723&partnerID=8YFLogxK
U2 - 10.3389/fmicb.2019.00613
DO - 10.3389/fmicb.2019.00613
M3 - Article
AN - SCOPUS:85065149723
SN - 1664-302X
VL - 10
JO - Frontiers in Microbiology
JF - Frontiers in Microbiology
M1 - 613
ER -