Monitoring the dynamics of the HIV epidemic using assays for recent infection and serotyping among new HIV diagnoses: experience after 2 years in France.
BACKGROUND
New tools to better monitor dynamics of human immunodeficiency virus (HIV) transmission are needed.


METHODS
National surveillance of newly HIV diagnoses included the collection of dried serum spots to identify both recent infections (<6 months) and HIV serotypes. Multivariate analyses were used to identify factors associated with recent infection and infection with non-B subtypes.


RESULTS
Between 2003 and March 2005, 7902 new HIV diagnoses were reported. The overall proportion of recent infections was 24.9% (95% confidence interval, 23.8%-26.0%) and was highest among men who have sex with men (MSM; 46%). Recent infection was associated with being an MSM, <30 years old, of French nationality, and living in Paris. Nearly half of newly HIV-1 diagnoses were with non-B subtypes. The highest proportion of non-B infections was reported among African heterosexual persons (81%), but important proportions were reported among French heterosexual persons (34%) and MSM (12%). Being infected by a non-B subtype was independently associated with being African, <30 years old, heterosexual, and living in Paris. The proportion of HIV-2 infection was 1.9%, and 11 cases of HIV-1 group O infection were identified, mainly among West Africans.


CONCLUSIONS
There is evidence of high levels of HIV transmission among MSM in France and transmission of non-B subtypes within the indigenous French population.
Semaille
Caroline
C
Institut de Veille Sanitaire, Saint Maurice, 94 415, France. c.semaille@invs.sante.fr
Barin
Francis
F
Cazein
Francoise
F
Pillonel
Josiane
J
Lot
Florence
F
Brand
Denys
D
Plantier
Jean-Christophe
JC
Bernillon
Pascale
P
Le Vu
Stéphane
S
Pinget
Roselyne
R
Desenclos
Jean-Claude
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D004196:Disease Outbreaks; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D008297:Male; D010802:Phylogeny; D012307:Risk Factors; D013997:Time Factors