Identification of a Human Immunodeficiency Virus Type 1 and Neurosyphilis Cluster in Vermont
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Identification of a Human Immunodeficiency Virus Type 1 and Neurosyphilis Cluster in Vermont

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English
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  • Alternative Title:
    Clin Infect Dis
  • Personal Author:
  • Description:
    Background.

    Rates of syphilis in the United States have more than doubled over the last several decades, largely among men who have sex with men (MSM). Our study characterizes a cluster of neurosyphilis cases among people with human immunodeficiency virus 1 (HIV-1) in Vermont in 2017–2018.

    Methods.

    Vermont Department of Health disease intervention specialists conduct interviews with newly diagnosed HIV-1 cases and pursue sexual networking analyses. Phylogenetic and network analyses of available Vermont HIV-1 polymerase (pol) sequences identified clusters of infection. Fishers-exact and independent t-tests were used to compare people with HIV-1 within or outside an identified cluster.

    Results.

    Between 1 January 2017 and 31 December 2018, 38 residents were diagnosed with HIV-1 infection. The mean age was 35.5 years, 79% were male and 82% were White. Risk factors for HIV-1 included MSM status (79%) and methamphetamine use (21%). Eighteen cases (49%) had HIV-1 viral loads (VLs) >100 000 copies/mL and 47% had CD4 cell counts <200/mm3. Eleven of the 38 (29%) had positive syphilis serology, including four (36%) with neurosyphilis. Sexual networking analysis revealed a ten-person cluster with higher VLs at diagnosis (90% with VLs > 100 000 copies/mL vs 33%, P = 0.015). Phylogenetic analysis of pol sequences showed a cluster of 14 cases with sequences that shared 98%–100% HIV-1 nucleotide identity.

    Conclusions.

    This investigation of newly infected HIV-1 cases in Vermont led to identification of a cluster that appeared more likely to have advanced HIV-1 disease and neurosyphilis, supported by phylogenetic and network analyses.

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  • Source:
    Clin Infect Dis. 73(9):e3244-e3249
  • Pubmed ID:
    33289032
  • Pubmed Central ID:
    PMC11318571
  • Document Type:
    Journal Article
  • Funding:
    CC999999/ImCDC/Intramural CDC HHSUnited States/
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