Molecular Epidemiology of HIV-1 Infected Migrants Followed up in Portugal: Trends between 2001-2017.

Victor Pimentel,M Rosário O Martins,Andrea-Clemencia Pineda-Peña,Pieter Libin,Isabel Diogo,Mafalda Miranda,Ricardo Camacho,Sandra Fernandes,Ana Abecasis,Perpétua Gomes,Anne-Mieke Vandamme,Daniela Alves,Marta Pingarilho

doi:10.3390/v12030268

Abstract

Migration is associated with HIV-1 vulnerability. Objectives: To identify long-term trends in HIV-1 molecular epidemiology and antiretroviral drug resistance (ARV) among migrants followed up in Portugal Methods: 5177 patients were included between 2001 and 2017. Rega, Scuel, Comet, and jPHMM algorithms were used for subtyping. Transmitted drug resistance (TDR) and Acquired drug resistance (ADR) were defined as the presence of surveillance drug resistance mutations (SDRMs) and as mutations of the IAS-USA 2015 algorithm, respectively. Statistical analyses were performed. Results: HIV-1 subtypes infecting migrants were consistent with the ones prevailing in their countries of origin. Over time, overall TDR significantly increased and specifically for Non-nucleoside reverse transcriptase inhibitor (NNRTIs) and Nucleoside reverse transcriptase inhibitor (NRTIs). TDR was higher in patients from Mozambique. Country of origin Mozambique and subtype B were independently associated with TDR. Overall, ADR significantly decreased over time and specifically for NRTIs and Protease Inhibitors (PIs). Age, subtype B, and viral load were independently associated with ADR. Conclusions: HIV-1 molecular epidemiology in migrants suggests high levels of connectivity with their country of origin. The increasing levels of TDR in migrants could indicate an increase also in their countries of origin, where more efficient surveillance should occur.

Highlights

In the latest years, the number of migrants has dramatically increased globally [1]
Late diagnosis is a feature of the human immunodeficiency virus (HIV) epidemic among migrants, it means that migrants are at risk of low CD4 counts at diagnosis, increased morbidity, mortality, and onward transmission
A total of 5177 HIV-1 sequences were included in the analysis and consisted of 1281 (24%) of HIV-1 adult migrants from Portuguese-speaking African countries (PALOP), 209 (4%) from Brazil and 3687 (72%) Portuguese-originated patients, followed up between 2001 and 2017

Summary

Introduction

The number of migrants has dramatically increased globally [1]. Almost258 million people live outside their home country [1]. The number of migrants has dramatically increased globally [1]. 3% of the world’s population and have different backgrounds. This phenomenon has contributed to increasing health problems amongst migrants in high-income countries, including vulnerability for HIV acquisition and other sexual health issues [1]. In 2017, migrants account for 41% of newly diagnosed cases of human immunodeficiency virus (HIV) infection in the European Union/European. Late diagnosis is a feature of the HIV epidemic among migrants, it means that migrants are at risk of low CD4 counts at diagnosis, increased morbidity, mortality, and onward transmission. European surveillance data indicates that some migrant groups are more than twice as likely to be diagnosed late as non-migrants [3]

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Conclusion