Abstract Cyprus

Theme 3: Epidemiology

International Symposium HIV & Emerging Infectious Diseases 2016

25-27 May, France

 

Requirements: Your abstract should not exceed 2,000 characters. All abstracts should be submitted in English. The summary must be structured as below: a. Introduction (Aim) b. Materials and Methods c. Results d. Conclusions

 

Title: To be defined

Possibilities: Young adults drive the onward transmission of HIV-1 in Cyprus

Molecular Epidemiology of HIV-1 in Cyprus

 

Andrea-Clemencia Pineda-Peña 1,2*, Kristof Theys 3*, Ana Barroso Abecasis1, Leondios G. Kostrikis4,

 

1 Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal

2 Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC) and Basic Sciences Department, Universidad del Rosario, Bogotá, Colombia

3 Clinical and Epidemiological Virology, Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven

4 Laboratory of Biotechnology and Molecular Virology, Department of Biological Sciences, University of Cyprus

* These authors contributed equally to this work

†  Corresponding author

 

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Introduction: The study of local HIV epidemics becomes essential to formulate tailored prevention policies. Since there is not a recent survey about the molecular epidemiology of HIV-1 in Cyprus, we aimed to determine the prevalence of subtypes, transmitted drug resistance and the factors that may have led to the self-sustainment of this epidemic.

 

Materials and Methods: A total of 335 patients from the Cyprus Reference AIDS Clinic, Larnaca National Hospital were included between 2003 and 2012. HIV-1 pol sequences were subtyped with REGAv3, COMETv1.0 and manual phylogenetic analysis. Transmitted Drug Resistance (TDR) was evaluated in 204 naive patients according to the WHO-2009 surveillance list. To determine transmission clusters (TC), maximum likelihood trees were performed with the most prevalent subtypes and four additional control datasets. The TC were identified according to a genetic distance of <0.045 and 98% of bootstrap support. Logistic regression analyses were used to evaluate factors associated with TC.


Results:  69% of the population was originated in Cyprus and 49% reported men who have sex with men (MSM) as likely route of transmission. The overall TDR prevalence was 3.5% (95% confidence interval (CI): XX-XX). Resistance for nucleoside reverse transcriptase inhibitors (NRTI) was XX% (CI: XX-XX), for non-NRTI was xx (CI: XX-XX), and for protease inhibitors was xx% (CI: XX-XX). The most prevalent subtypes in the total population were B (54%), followed by A1 (20%), C (9%), CRF02_AG (6%) and F1 (6%), which were included in the TC analyses. 47 (of which 20 had a size > 2) TC were identified. 31% of the Cypriot patients (96/307) were included in TCs, 75% were male, 57% were between 25 and 45 years old, 51% were MSM, 41% were living in Nicosia and 45% reported being infected in Cyprus. 54% of the patients in a TC were infected with subtype B followed by 25% with subtype A1. The single factor associated with being in a TC was age between 25 and 45 years in the multivariate analyses. When B and the non-B sub-epidemics were compared, Cypriots were mostly over 45 years old (65%), MSM (86%) and infected with subtype B.  

INcrease  of non-native over time (in years):  yes, subtype F1 ?  
Age at diagnosis is decreasing over time  very clear (most in msm)

Conclusions: TDR prevalence remains low. The spread of HIV was significantly associated with young adults, who should be targeted for prevention policies more intensively.