Antonio Camiro-Zuñiga

Acute HIV infection (AHI) represents a diagnosis challenge worldwide while representing an attractive target for preventive interventions due to the high infectivity that the patients present in this phase. In this session we saw new approaches to tackle this difficult subject in prevention science.

Dennis presented genetic clusters in AHI in North Carolina. They identified 152 clusters involving 1202 persons. AHI patients tended to converge in clusters and, over time, the size of these clusters grew. Avila-Rios showed genetic HIV networks in two Mexican cities. All clusters tended to contain young MSM, and showed different dynamics. In Jalisco, the inferred transmission route was dependent on age and municipality of residence, while in Mexico City, the inferred transmission network did not. Skaathun showed genetic clusters in AHI patients in Tijuana, Mexico. AHI patients represented 11% of the patients, and were more likely to cluster (64%). Those with recent infection lived in Tijuana longer and were more likely to use cocaine. Giang Le showed a high prevalence of AHI (21.6%), occurring mostly in young MSM. Guanira showed AHI detection during the ImPrEP trial, with a total of 9 patients identified (0.26%).

Genetic clustering is shaping up to play a central role in the planning process of future interventions for HIV prevention. Identifying patients with a high infectivity rate and understanding the transmission mechanics amongst them and the rest of the community will enhance our ability to stop transmissions before they occur at a community-wide level. Enhanced partner services for MSM to support retention in HIV care and facilitate further case finding may have a high impact on reducing onward transmission.