Author(s): the BESTHOPE Study Group ; Pingarilho, Marta ; Pimentel, Victor ; Miranda, Mafalda N.S. ; Mansinho, Kamal ; Martins, Maria Rosário O. ; Abecasis, Ana
Date: 2022
Persistent ID: http://hdl.handle.net/10362/143386
Origin: Repositório Institucional da UNL
Subject(s): HIV-1; newly infected patients; Portugal; TDR; transmission clusters; Microbiology; Microbiology (medical); Epidemiology; SDG 3 - Good Health and Well-being
Funding Information: This study was supported by the European funds through 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 and GHTM-UID/04413/2020; by the MigrantHIV project (financed by FCT: PTDC/DTP-EPI/7066/2014); by Characterization of drug-resistance TB and HIV, and associated sociobehavioral factors among migrants in Lisbon, Portugal project financed by GHTM-UID/Multi/04413/2013; and by Integriv project (financed by FCT: PTDC/SAU-INF/31990/2017). Publisher Copyright: Copyright © 2022 Pingarilho, Pimentel, Miranda, Silva, Diniz, Ascenção, Piñeiro, Koch, Rodrigues, Caldas, Morais, Faria, da Silva, Teófilo, Monteiro, Roxo, Maltez, Rodrigues, Gaião, Ramos, Costa, Germano, Simões, Oliveira, Ferreira, Poças, da Cunha, Soares, Henriques, Mansinho, Pedro, Aleixo, Gonçalves, Manata, Mouro, Serrado, Caixeiro, Marques, Costa, Pacheco, Proença, Rodrigues, Pinho, Tavares, de Abreu, Côrte-Real, Serrão, Castro, Nunes, Faria, Baptista, Martins, Gomes, Mendão, Simões and Abecasis.
Objective: To describe and analyze transmitted drug resistance (TDR) between 2014 and 2019 in newly infected patients with HIV-1 in Portugal and to characterize its transmission networks. Methods: Clinical, socioepidemiological, and risk behavior data were collected from 820 newly diagnosed patients in Portugal between September 2014 and December 2019. The sequences obtained from drug resistance testing were used for subtyping, TDR determination, and transmission cluster (TC) analyses. Results: In Portugal, the overall prevalence of TDR between 2014 and 2019 was 11.0%. TDR presented a decreasing trend from 16.7% in 2014 to 9.2% in 2016 (pfor–trend = 0.114). Multivariate analysis indicated that TDR was significantly associated with transmission route (MSM presented a lower probability of presenting TDR when compared to heterosexual contact) and with subtype (subtype C presented significantly more TDR when compared to subtype B). TC analysis corroborated that the heterosexual risk group presented a higher proportion of TDR in TCs when compared to MSMs. Among subtype A1, TDR reached 16.6% in heterosexuals, followed by 14.2% in patients infected with subtype B and 9.4% in patients infected with subtype G. Conclusion: Our molecular epidemiology approach indicates that the HIV-1 epidemic in Portugal is changing among risk group populations, with heterosexuals showing increasing levels of HIV-1 transmission and TDR. Prevention measures for this subpopulation should be reinforced.
