Abstract
Abstract
Introduction
Although women comprise 33% of the HIV-1-carriers in Israel, they have not previously been considered a risk group requiring special attention. Immigration waves from countries in Africa and in East Europe may have changed the local landscape of women diagnosed with HIV-1. Here, we aimed to assess viral and demographic characteristics of HIV-1-positive women identified in Israel between 2010 and 2018.
Methods
All > 16 year-old, HIV-1-infected women, diagnosed in Israel in 2010–2018, (n = 763) registered in the National HIV reference laboratory were included in this cross-sectional study. Demographic and clinical characteristics were extracted from the database. Viral subtypes and transmitted drug resistance mutations (TDRM) were determined in 337 (44.2%) randomly selected samples collected from treatment-naive women.
Results
Median age at diagnosis was 38 years. Most (73.3%) women were immigrants from the former Soviet Union (FSU) (41.2%, 314) or sub-Saharan Africa (SSA) (32.2%, 246) and carried subtype A (79.7%) or C (90.3%), respectively. Only 11.4% (87) were Israeli-born women. Over the years, the prevalence of women from SSA decreased while that of women from FSU increased significantly (p < 0.001). The median CD4+ cell count was 263 cells/mm3, and higher (391 cells/mm3) in Israeli-born women. TDRM were identified in 10.4% of the tested samples; 1.8, 3 and 7.1% had protease inhibitors (PI), nucleotide reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) TDRM, respectively. The prevalence of women with NNRTI TDRM significantly increased from 4.9% in 2010–2012 to 13.3% in 2016–2018. Israeli-born women had the highest prevalence (16.3%) of NNRTI TDRM (p = 0.014). NRTI A62 (5.6%), NNRTI E138 and K103 (5.6 and 4.2%, respectively) were the most prominent mutated sites.
Conclusions
Most HIV-1-positive women diagnosed in Israel in 2010–2018 were immigrants, with the relative ratio of FSU immigrants increasing in recent years. The high proportion of women diagnosed with resistance mutations, particularly, the yearly increase in the frequency of NNRTI mutations, support the national policy of resistance testing at baseline.
Publisher
Springer Science and Business Media LLC
Reference30 articles.
1. UNAIDS. Women and girls and HIV: UNAIDS; 2018. [cited 2019 Nov 14]. Available from: https://www.unaids.org/sites/default/files/media_asset/women_girls_hiv_en.pdf.
2. UN WOMEN. Facts and figures: HIV and AIDS: UN WOMEN; 2018. [cited 2019 Nov 14]. Available from: https://www.unwomen.org/en/what-we-do/hiv-and-aids/facts-and-figures.
3. Wilson D, Halperin DT. Know your epidemic, know your response: a useful approach, if we get it right. Lancet. 2008;372(9637):423–6.
4. Rechel B. HIV/AIDS in the countries of the former Soviet Union: societal and attitudinal challenges. Cent Eur J Public Health. 2010;18(2):110–5.
5. Boucher CA, Bobkova MR, Hung C-C, Kaiser R, Marcelin A-G, Streinu-Cercel A, et al. State of the art in HIV drug resistance: surveillance and regional gaps. AIDS Rev. 2018;20(1):43–57.
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