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

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Singh, Devika ; Switzer, William M. ; Belcher, Roy ; Daltry, Daniel ; Read, Jennifer S.
• 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.
  
  
• Subjects:
  Adult HIV-1 HIV Infections Homosexuality, Male Humans Male Neurosyphilis Phylogeny Sexual And Gender Minorities Syphilis Vermont

  More +
• Keywords:
  Neurosyphilis Syphilis
• 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/
• Volume:
  73
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:86ec3ab6808283f382eb6a429ca2e08d7d3143f634ff291de1cef7635495888c747ab9ac5fbaf4b0a884f2d5e1a199c69e8b50995bfc9836fa81bc9ed4046082
• Download URL:
  https://stacks.cdc.gov/view/cdc/159832/cdc_159832_DS1.pdf
• File Type:
  [PDF - 499.58 KB ]