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Chronic, Acute, and Reactivated HIV Infection in Humanized Immunodeficient Mouse Models

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Discriminating Between Premigration and Postmigration HIV Acquisition Using Surveillance Data.

Nikos Pantazis¹, Magdalena Rosinska², Ard van Sighem³

¹Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

Journal of Acquired Immune Deficiency Syndromes (1999)

|June 17, 2021

Summary

This summary is machine-generated.

A new method estimates when migrants acquire HIV, finding a significant portion contract the virus after arriving in destination countries. This is crucial for public health interventions and understanding HIV incidence in migrant populations.

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Area of Science:

Epidemiology
Biostatistics
Public Health

Background:

Migrant populations show disproportionately high rates of HIV diagnoses in the EU/EEA.
Determining the timing of HIV acquisition (pre- or postmigration) is vital for effective public health strategies and accurate HIV incidence estimation.
Accurate timing data aids in identifying individuals with undiagnosed HIV infections within migrant communities.

Purpose of the Study:

To present and apply a novel method for determining the timing of HIV acquisition in migrant populations.
To assess the performance of this method using both simulated and real-world surveillance data.
To estimate the proportion of HIV infections acquired postmigration among different migrant groups.

Main Methods:

A Bayesian framework combining a mixed-effects model from seroconverter data with biomarker measurements and individual characteristics.
Application of the method to a subset of data from the European Surveillance System (TESSy) and simulated datasets.
Validation of the method's performance with single CD4 count measurements, showing satisfactory results.

Main Results:

Simulation studies demonstrated high classification accuracy: 87.4% for premigration and 80.4% for postmigration HIV acquisition.
Analysis of TESSy data indicated substantial postmigration HIV acquisition: 31.9% (Africa), 37.1% (Europe), 45.3% (Asia), and 45.2% (other regions).

Conclusions:

A significant proportion of HIV infections among migrants occur after arrival in destination countries.
The developed method is robust, even with limited biomarker data (e.g., single CD4 count).
Findings have critical implications for tailoring public health policies and interventions for migrant populations to address HIV prevention and care.