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Projected effectiveness of hiv detection during early infection and rapid ART initiation among MSM and transgender women in Peru: A modeling study

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Infectious Disease Modelling 2019年第1期4卷 73-82页

作者： Dobromir Dimitrov Daniel Wood Angela Ulrich David A.Swan Blythe Adamson Javier R.Lama Jorge Sanchez Ann Duerr Vaccine and Infectious Diseases Division Fred Hutchinson Cancer Research CenterSeattleWAUSA Department of Global Health University of WashingtonSeattleWAUSA Comparative Health Outcomes Policy&Economics(CHOICE)InstituteUniversity of WashingtonSeattleWAUSA Asociacion Civil Impacta Salud y Educacion LimaPeru Centro de Investigaciones Tecnologicas Biomedicas y MedioambientalesUniversidad Mayor de San MarcosLimaPeru

Background:The Sabes study,a treatment as prevention intervention in Peru,tested the hypothesis that initiating antiretroviral therapy(ART)early in hiv infection when viral load is high,would markedly reduce onward hiv transmission among high-risk men who have sex with men(MSM)and transgender women(TW).We investigated the potential population-level benefits of detection of hiv early after acquisition and rapid initiation of ***:We designed a transmission dynamic model to simulate the hiv epidemic among MSM and TW in Peru,calibrated to data on hiv prevalence and ART coverage from 2004 to *** assessed the impact of an intervention starting in 2018 in which up to 50%of the new infections were diagnosed within three months of acquisition and initiated on ART within 1 month of *** estimated the impact of the intervention over 20 years using the cumulative prevented fraction of new hiv infections compared to scenarios without ***:Our model suggests that only 19%of the infected MSM and TW are virally suppressed in 2018 and 35%e40%of the new hiv infections are transmitted from contacts with acutely-infected *** intervention reaching 10%of all acutely infected MSM and TW is projected to prevent 13.3%[Uncertainty interval:11.9%e14.3%]of the new infections over 20 years and reduce hiv incidence in 2038 by 24%.Reaching 50%of all acutely infected MSM and TWwill increase the prevalence of viral suppression in 2038 to 59%and prevent 41%of expected infections over 20 *** 50%of the high-risk MSM and TW in acute phase would reduce hiv incidence in 2038 by 60%and prevent 36%of new infections between 2018 and ***:Early detection of hiv infections and rapid initiation of ART among MSM is desirable as it would increase the effectiveness of the hiv prevention program in *** high-risk MSM and TW will be highly efficient.

关键词： Mathematical model Antiretroviral therapy hiv incidence hiv prevention

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Modelling the dynamics of population viral load measures under hiv treatment as prevention

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Infectious Disease Modelling 2018年第1期3卷 160-170页

作者： Ganna Rozhnova Marilena Anastasaki Mirjam Kretzschmar Julius Center for Health Sciences and Primary Care University Medical Centre UtrechtUtrechtthe Netherlands Centre for Infectious Disease Control National Institute of Public Health and the EnvironmentBilthoventhe Netherlands

In 2011 the Centers for Disease Control and Prevention(CDC)published guidelines for the use of population viral load(PVL),community viral load(CVL)and monitored viral load(MVL),defined as the average viral load(VL)of all hiv infected individuals in a population,of all diagnosed individuals,and of all individuals on antiretroviral treatment(ART),*** then,CVL has been used to assess the effectiveness of ART on hiv transmission and as a proxy for hiv *** first objective of this study was to investigate how aggregate VL measures change with the hiv epidemic phase and the drivers behind these changes using a mathematical transmission ***,we aimed to give some insight into how well CVL correlates with hiv incidence during the course of the epidemic and roll out of *** developed a compartmental model for disease progression and hiv transmission with disease stages that differ in viral loads for epidemiological scenarios relevant to a concentrated epidemic in a population of men who have sex with men(MSM)in Western Europe(WE)and to a generalized epidemic in a heterosexual population in Sub-Saharan Africa(SSA).The model predicts that PVL and CVL change with the epidemic phase,while MVL stays *** dynamics are linked to the dynamics of infected subgroups(undiagnosed,diagnosed untreated and treated)in different disease stages(primary,chronic and AIDS).In particular,CVL decreases through all epidemic stages:before ART,since chronic population builds up faster than AIDS population and after ART,due to the build-up of treated population with low *** trends in CVL and incidence can be both opposing and coinciding depending on the epidemic *** ART is scaled up to sufficiently high levels,incidence increases while CVL *** this point,CVL is a useful indicator of changes in hiv *** model predicts that during the ART scale-up hiv transmission is driven by undiagnosed and diagnosed untreated individuals,a

关键词： Population viral load measures Mathematical model hiv incidence Community viral load Monitored viral load Population viral load

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Detection of recent hiv-1 infections among men who have sex with men in Beijing during 2005-2006

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Chinese Medical Journal 2008年第12期121卷 1105-1108页

作者： LI Shen-wei ZHANG Xiao-yan LI Xin-xu WANG Min-jie LI Dong-liang RUAN Yu-hua ZHANG Xiao-xi SHAO Yi-ming State Key Laboratory for Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention China CDC Beijing 100050 China Chaoyang District Center for AIDS/STD Control and Prevention Beijing 100021 China

Background Men who have sex with men （MSM） have become one of the most risky populations for hiv infection in China. Though several cross-sectional sero-prevalence studies have been conducted, the annual hiv incidence remains unknown in this population.Methods We applied IgG-capture BED-enzyme immunoassay （BED-CEIA） to define the recent hiv-1 infections among MSM in Beijing in the years 2005 and 2006 and the annual hiv incidence was estimated.Results Overall, 1067 MSM samples were collected, including 526 samples in the year 2005 and 541 in 2006. In 2005, of 17 hiv seropositive samples, 7 were identified as recent hiv-1 infections and the estimated hiv infection incidence was 2.9% per year （95% CI, 0.8%-5.0%）. In 2006, of 26 hiv seropositive samples, 9 were identified as recent hiv-1 infections and the estimated annual incidence was 3.6% （95% CI, 1.3%-5.9%）, which was 0.7% higher than that in 2005. Individuals engaging in male group sexual intercourse （5.17% vs 0.87%, P=0.019） and having receptive anal sexual intercourse more than five times （2.79% vs 0.33%, P=0.047） in the past 6 months significantly increase the risk of being infected by hiv-1.Conclusions A high level of annual hiv-1 infection incidence was observed among MSM in Beijing for the consecutive years 2005 and 2006 with a continuous increasing trend. The rising incidence and related high risk behavior among MSM alarmed the health authorities and calls for more effective intervention strategies among this population.

关键词： hiv-1 men who have sex with men hiv incidence IgG-capture BED-enzyme immunoassay

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Disparity of human immunodeficiency virus incidence and drug resistance in college student,non-student youth and older men who have sex with men:a cross-sectional study from seven major cities of China

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Chinese Medical Journal 2020年第23期133卷 2778-2786页

作者： Jing Zhang Jun-Jie Xu Zhen-Xing Chu Qing-Hai Hu Xiao-Xu Han Bin Zhao Yong-Jun Jiang Wen-Qing Geng Hong Shang NHC Key Laboratory of AIDS Immunology(China Medical University) National Clinical Research Center for Laboratory MedicineThe First Affiliated Hospital of China Medical UniversityShenyangLiaoning 110001China Key Laboratory of AIDS Immunology Chinese Academy of Medical SciencesShenyangLiaoning 110001China Key Laboratory of AIDS Immunology of Liaoning Province ShenyangLiaoning 110001China

Background:Human immunodeficiency virus(hiv)prevalence among student men who have sex with men(MSM)in college is more than 5.0%and keeps on increasing in *** study aims to clarify the proportion of hiv recent infection,its propeller and the source among college student ***:We conducted a multicenter cross-sectional study in seven major Chinese cities during *** recent infections(≤168 days)and incidence was measured and estimated by BED hiv-1 capture enzyme immunoassay(BED-CEIA)testing ***-related behaviors and transmitted drug resistance(TDR)were investigated and compared between the college student MSM,hiv recent infection were 70.3%(26/37),50.8%(65/128)and 35.1%(95/271),the hiv incidence rate were 10.0(95%CI:6.2-13.9)/100 person-year(PY),12.9(95%CI:9.8-16.1)/100PY,6.8(95%CI:5.4-8.2)/100 PY,and TDR prevalences were 7.4%(2/27),2.0%,(2/98)and 4.9%(11/226),among student MSM,NSYM,and NSNYM,*** hiv positive student MSM with agehiv recent infection is 90.9%(10/11).Factors independently associated with hiv recent infection in student MSM was usage of recreational drug in the past 6 months(adjusted odds ratio[aOR]:2.5;95%CI:1.0-5.8).Conclusions:College student MSM had higher proportion of hiv recent infection and TDR than the youth and older MSM in China during *** hiv infections were more likely to happen during the early year of college life among student MSM.

关键词： hiv incidence Drug resistance Men who have sex with men Male Students Cross-sectional studies Sexual behavior

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