New HIV-1 circulating recombinant form 94: from phylogenetic detection of a large transmission cluster to prevention in the age of geosocial-networking apps in France, 2013 to 2017

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 24; no. 39; p. 1
• Main Authors: Wirden, Marc, De Oliveira, Fabienne, Bouvier-Alias, Magali, Lambert-Niclot, Sidonie, Chaix, Marie-Laure, Raymond, Stéphanie, Si-Mohammed, Ali, Alloui, Chakib, André-Garnier, Elisabeth, Bellecave, Pantxika, Malve, Brice, Mirand, Audrey, Pallier, Coralie, Poveda, Jean-Dominique, Rabenja, Theresa, Schneider, Veronique, Signori-Schmuck, Anne, Stefic, Karl, Calvez, Vincent, Descamps, Diane, Plantier, Jean-Christophe, Marcelin, Anne-Genevieve, Visseaux, Benoit
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 26-09-2019; European Centre for Disease Prevention and Control; European Centre for Disease Prevention and Control (ECDC)
• Subjects: Adult; Antiretroviral drugs; Bacteriology; Cluster Analysis; Disease Outbreaks - prevention & control; DNA, Viral - genetics; Drug Resistance, Viral - genetics; France - epidemiology; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - transmission; HIV Infections - virology; HIV-1 - classification; HIV-1 - genetics; HIV-1 - pathogenicity; Human immunodeficiency virus; Humans; Life Sciences; Male; Men; Microbiology and Parasitology; Mycology; Online Social Networking; Phylogeny; Phylogeography; Protistology; Recombination, Genetic; Reverse Transcriptase Polymerase Chain Reaction; Sequence Alignment; Sexual and Gender Minorities - statistics & numerical data; Sexual behavior; Studies; Surveillance; Viral Load; Viremia - virology; Virology; Virulence; Whole Genome Sequencing; France; HIV CRF94; HIV Prevention; phylogenetic analysis; HIV Outbreak; HIV cluster
• ISSN: 1560-7917; 1025-496X; 1560-7917; 1025-496X
• DOI: 10.2807/1560-7917.ES.2019.24.39.1800658

BackgroundEnding the HIV pandemic must involve new tools to rapidly identify and control local outbreaks and prevent the emergence of recombinant strains with epidemiological advantages.AimThis observational study aimed to investigate in France a cluster of HIV-1 cases related to a new circulating recombinant form (CRF). The confirmation this CRF's novelty as well as measures to control its spread are presented.MethodsPhylogenetic analyses of HIV sequences routinely generated for drug resistance genotyping before 2018 in French laboratories were employed to detect the transmission chain. The CRF involved was characterised by almost full-length viral sequencing for six cases. Cases' clinical data were reviewed. Where possible, epidemiological information was collected with a questionnaire.ResultsThe transmission cluster comprised 49 cases, mostly diagnosed in 2016-2017 (n = 37). All were infected with a new CRF, CRF94_cpx. The molecular proximity of this CRF to X4 strains and the high median viraemia, exceeding 5.0 log
 copies/mL, at diagnosis, even in chronic infection, raise concerns of enhanced virulence. Overall, 41 cases were diagnosed in the Ile-de-France region and 45 were men who have sex with men. Among 24 cases with available information, 20 reported finding partners through a geosocial networking app. Prevention activities in the area and population affected were undertaken.ConclusionWe advocate the systematic use of routinely generated HIV molecular data by a dedicated reactive network, to improve and accelerate targeted prevention interventions. Geosocial networking apps can play a role in the spread of outbreaks, but could also deliver local targeted preventive alerts.