Abstract
IntroductionAlthough women comprise 33% of the HIV-1-carriers in Israel, they have not previously been considered a risk group requiring special attention. Immigration waves from countries in Africa and in East Europe may have changed the local landscape of women diagnosed with HIV-1. Here, we aimed to assess viral and demographic characteristics of HIV-1-positive women identified in Israel between 2010 and 2018.MethodsAll > 16 year-old, HIV-1-infected women, diagnosed in Israel in 2010–2018, (n = 763) registered in the National HIV reference laboratory were included in this cross-sectional study. Demographic and clinical characteristics were extracted from the database. Viral subtypes and transmitted drug resistance mutations (TDRM) were determined in 337 (44.2%) randomly selected samples collected from treatment-naive women.ResultsMedian age at diagnosis was 38 years. Most (73.3%) women were immigrants from the former Soviet Union (FSU) (41.2%, 314) or sub-Saharan Africa (SSA) (32.2%, 246) and carried subtype A (79.7%) or C (90.3%), respectively. Only 11.4% (87) were Israeli-born women. Over the years, the prevalence of women from SSA decreased while that of women from FSU increased significantly (p < 0.001). The median CD4+ cell count was 263 cells/mm3, and higher (391 cells/mm3) in Israeli-born women. TDRM were identified in 10.4% of the tested samples; 1.8, 3 and 7.1% had protease inhibitors (PI), nucleotide reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) TDRM, respectively. The prevalence of women with NNRTI TDRM significantly increased from 4.9% in 2010–2012 to 13.3% in 2016–2018. Israeli-born women had the highest prevalence (16.3%) of NNRTI TDRM (p = 0.014). NRTI A62 (5.6%), NNRTI E138 and K103 (5.6 and 4.2%, respectively) were the most prominent mutated sites.ConclusionsMost HIV-1-positive women diagnosed in Israel in 2010–2018 were immigrants, with the relative ratio of FSU immigrants increasing in recent years. The high proportion of women diagnosed with resistance mutations, particularly, the yearly increase in the frequency of NNRTI mutations, support the national policy of resistance testing at baseline.
Highlights
Women comprise 33% of the HIV-1-carriers in Israel, they have not previously been considered a risk group requiring special attention
Most HIV-1-positive women diagnosed in Israel in 2010–2018 were immigrants, with the relative ratio of Former Soviet Union (FSU) immigrants increasing in recent years
The high proportion of women diagnosed with resistance mutations, the yearly increase in the frequency of nucleoside reverse transcriptase inhibitors (NNRTI) mutations, support the national policy of resistance testing at baseline
Summary
Women comprise 33% of the HIV-1-carriers in Israel, they have not previously been considered a risk group requiring special attention. We aimed to assess viral and demographic characteristics of HIV-1-positive women identified in Israel between 2010 and 2018. The proportion of newly infected women varies around the world [2], with the majority (56%) living in Sub–Saharan Africa (SSA) [2], a region suffering from a generalized HIV-1 epidemic (> 1% HIV-1 prevalence) [3]. The second major region with a high proportion of HIV-1positive women (42%) is Eastern Europe, countries in the Former Soviet Union (FSU), which experienced the fastest growing HIV-1 epidemic in the world [4] between 2003 and 2009, and is currently regarded as a region of concentrated HIV-1 infection [3]. Immigrants from countries with high rates of HIV-1 infection and of viruses with resistance mutations, may be infected and continuously transmit drug-resistant viruses after immigration [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
