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The molecular epidemiology of HIV-1 in Sweden 1996 to 2022, and the influence of migration from Ukraine

Weibull Wärnberg, Anna ; Brännström, Johanna ; Elvstam, Olof LU orcid ; Gisslén, Magnus ; Månsson, Fredrik LU ; Sönnerborg, Anders and van de Klundert, Maarten AA (2023) In Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 28(48).
Abstract

BackgroundThe global distribution of HIV-1 subtypes is evolving, which is reflected in the Swedish HIV cohort. The subtype HIV-1A6, which may be prone to developing resistance to cabotegravir, is the most common subtype in Ukraine.AimWe aimed to examine trends in HIV-1 subtype distribution in Sweden, with a special focus on HIV-1A6, and to describe the virology, demography and treatment of Ukrainian people living with HIV (PLWH) who migrated to Sweden in 2022.MethodsData about PLWH in Sweden are included in a national database (InfCareHIV). We used the online tool COMET to establish HIV-1 subtypes and the Stanford database to define drug resistance mutations. We investigated the relation between virological characteristics and... (More)

BackgroundThe global distribution of HIV-1 subtypes is evolving, which is reflected in the Swedish HIV cohort. The subtype HIV-1A6, which may be prone to developing resistance to cabotegravir, is the most common subtype in Ukraine.AimWe aimed to examine trends in HIV-1 subtype distribution in Sweden, with a special focus on HIV-1A6, and to describe the virology, demography and treatment of Ukrainian people living with HIV (PLWH) who migrated to Sweden in 2022.MethodsData about PLWH in Sweden are included in a national database (InfCareHIV). We used the online tool COMET to establish HIV-1 subtypes and the Stanford database to define drug resistance mutations. We investigated the relation between virological characteristics and demographic data.ResultsThe early epidemic was predominated by HIV-1 subtype B infections in people born in Sweden. After 1990, the majority of new PLWH in Sweden were PLWH migrating to Sweden, resulting in an increasingly diverse epidemic. In 2022, HIV-1A6 had become the sixth most common subtype in Sweden and 98 of the 431 new PLWH that were registered in Sweden came from Ukraine. We detected HIV RNA in plasma of 32 Ukrainian patients (34%), of whom 17 were previously undiagnosed, 10 had interrupted therapy and five were previously diagnosed but not treated. We found HIV-1A6 in 23 of 24 sequenced patients.ConclusionThe molecular HIV epidemiology in Sweden continues to diversify and PLWH unaware of their HIV status and predominance of HIV-1A6 should be considered when arranging care directed at PLWH from Ukraine.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
volume
28
issue
48
pages
13 pages
publisher
European Centre for Disease Prevention and Control (ECDC)
external identifiers
  • scopus:85178514892
  • pmid:38037731
ISSN
1560-7917
DOI
10.2807/1560-7917.ES.2023.28.48.2300224
language
English
LU publication?
yes
id
c80b304d-d78e-4408-910d-4a8344cc5f94
date added to LUP
2023-12-02 08:51:38
date last changed
2024-04-13 18:25:30
@article{c80b304d-d78e-4408-910d-4a8344cc5f94,
  abstract     = {{<p>BackgroundThe global distribution of HIV-1 subtypes is evolving, which is reflected in the Swedish HIV cohort. The subtype HIV-1A6, which may be prone to developing resistance to cabotegravir, is the most common subtype in Ukraine.AimWe aimed to examine trends in HIV-1 subtype distribution in Sweden, with a special focus on HIV-1A6, and to describe the virology, demography and treatment of Ukrainian people living with HIV (PLWH) who migrated to Sweden in 2022.MethodsData about PLWH in Sweden are included in a national database (InfCareHIV). We used the online tool COMET to establish HIV-1 subtypes and the Stanford database to define drug resistance mutations. We investigated the relation between virological characteristics and demographic data.ResultsThe early epidemic was predominated by HIV-1 subtype B infections in people born in Sweden. After 1990, the majority of new PLWH in Sweden were PLWH migrating to Sweden, resulting in an increasingly diverse epidemic. In 2022, HIV-1A6 had become the sixth most common subtype in Sweden and 98 of the 431 new PLWH that were registered in Sweden came from Ukraine. We detected HIV RNA in plasma of 32 Ukrainian patients (34%), of whom 17 were previously undiagnosed, 10 had interrupted therapy and five were previously diagnosed but not treated. We found HIV-1A6 in 23 of 24 sequenced patients.ConclusionThe molecular HIV epidemiology in Sweden continues to diversify and PLWH unaware of their HIV status and predominance of HIV-1A6 should be considered when arranging care directed at PLWH from Ukraine.</p>}},
  author       = {{Weibull Wärnberg, Anna and Brännström, Johanna and Elvstam, Olof and Gisslén, Magnus and Månsson, Fredrik and Sönnerborg, Anders and van de Klundert, Maarten AA}},
  issn         = {{1560-7917}},
  language     = {{eng}},
  number       = {{48}},
  publisher    = {{European Centre for Disease Prevention and Control (ECDC)}},
  series       = {{Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin}},
  title        = {{The molecular epidemiology of HIV-1 in Sweden 1996 to 2022, and the influence of migration from Ukraine}},
  url          = {{http://dx.doi.org/10.2807/1560-7917.ES.2023.28.48.2300224}},
  doi          = {{10.2807/1560-7917.ES.2023.28.48.2300224}},
  volume       = {{28}},
  year         = {{2023}},
}