National molecular surveillance of recently acquired HIV infections in Germany, 2013 to 2014

Euro Surveill. 2017 Jan 12;22(2):30436. doi: 10.2807/1560-7917.ES.2017.22.2.30436.

Abstract

To enable an up-to-date molecular analysis of human immunodeficiency virus (HIV) genotypes circulating in Germany we have established a surveillance system based on recently acquired HIV infections. New HIV infections are reported to the Robert Koch Institute as a statutory duty for anonymous notification. In 2013 and 2014, a dried serum spot (DSS) sample was received from 6,371 newly diagnosed HIV-cases; their analysis suggested that 1,797 samples originated from a recent infection. Of these, 809 were successfully genotyped in the pol region to identify transmitted drug resistance (TDR) mutations and to determine the HIV-1 subtype. Total TDR was 10.8%, comprising 4.3% with mono-resistance to nucleoside reverse transcriptase inhibitors (NRTIs), 2.6% to non-NRTIs, 3.0% to protease inhibitors and 0.6% and 0.2%, respectively, with dual- and triple-class resistances. HIV-1 subtype B was most prevalent with 77.0%. Non-B infections were identified more often in men and women with heterosexual transmission compared with intravenous drug users or men who have sex with men (79% and 76%, 33%, 12%; all p < 0.05). Non-B subtypes were also more frequently found in patients originating from countries other than Germany (46% vs 14%; p < 0.05) and in patients infected outside of Germany (63% vs 14%; p < 0.05).

Keywords: HIV drug resistance; HIV subtype; Human immunodeficiency virus; dried serum spots; molecular surveillance; recency testing.

MeSH terms

  • Adult
  • Drug Resistance, Viral / genetics*
  • Female
  • Genetic Variation
  • Germany / epidemiology
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / transmission
  • HIV Infections / virology
  • HIV-1 / classification
  • HIV-1 / drug effects
  • HIV-1 / genetics*
  • Humans
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Mutation / drug effects
  • Mutation / genetics
  • Population Surveillance*
  • Prevalence
  • Protease Inhibitors / pharmacology*
  • Reverse Transcriptase Inhibitors / pharmacology*
  • Species Specificity
  • Young Adult
  • pol Gene Products, Human Immunodeficiency Virus / genetics*

Substances

  • Protease Inhibitors
  • Reverse Transcriptase Inhibitors
  • pol Gene Products, Human Immunodeficiency Virus