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Sex Transm Infect 85:106-110 doi:10.1136/sti.2008.031864
  • Epidemiology

Recently acquired HIV infection in Spain (2003–2005): introduction of the serological testing algorithm for recent HIV seroconversion

  1. A Romero1,2,3,
  2. V González1,2,4,
  3. M Granell1,
  4. L Matas2,4,
  5. A Esteve1,2,
  6. E Martró2,4,
  7. I Rodrigo5,
  8. T Pumarola6,
  9. J M Miró6,
  10. A Casanova7,
  11. E Ferrer7,
  12. C Tural8,
  13. J del Romero9,
  14. C Rodríguez9,
  15. E Caballero10,
  16. E Ribera10,
  17. J Casabona1,2,3,
  18. and the Standardized Algorithm for Recent HIV Infections (AERIVIH) study group
  1. 1
    Center for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), Institut Català d’Oncologia/Health Department, Generalitat de Catalunya, Spain
  2. 2
    CIBER Epidemiología y Salud Pública (CIBERESP), Spain
  3. 3
    Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
  4. 4
    Microbiology Service, Hospital Universitari Germans Trias i Pujol, Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Badalona, Spain
  5. 5
    Laboratori Clínic Manso, Barcelona, Spain
  6. 6
    Hospital Clínic – IDIBAPS, University of Barcelona, Barcelona, Spain
  7. 7
    Hospital Universitari de Bellvitge – IDIBELL, l’Hospitalet de Llobregat, Barcelona, Spain
  8. 8
    Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
  9. 9
    Centro Sanitario Sandoval, Madrid, Spain
  10. 10
    Hospital Universitari Vall Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
  1. Jordi Casabona, Center for Epidemiological Studies on HIV/aids and STI of Catalonia (CEEISCAT), Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Spain; jcb.ceescat.germanstrias{at}gencat.cat
  • Accepted 10 October 2008
  • Published Online First 5 November 2008

Abstract

Background: Identification of recent HIV infections provides a description of the current pattern of HIV transmission and, consequently, can help to design better preventive interventions. Our study shows the first implementation in Spain of the Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) strategy. We assess the viability of introducing STARHS in our setting and describe the frequency and epidemiological characteristics of recent infections (RIs).

Methods: Between 2003 and 2005, HIV-positive blood samples drawn for diagnostic purposes were collected from 28 Spanish laboratories to be tested using STARHS. Samples from patients with a previous HIV diagnosis, age <18 years, <200 CD4 cells/μL or clinical AIDS criteria were excluded from the analysis.

Results: A total of 660 (19.2%) samples were classified as RI. Most people identified with RI were male (79.8%) with a median age of 33.1 years, and 62.5% occurred among men who have sex with men (MSM). Immigrants made up 26.5% of individuals identified with RIs, with 48.7% coming from South America. Among the individuals with RI, at least 16.5% had reported another sexually transmitted infection (STI) during the year before the HIV diagnosis.

Conclusion: The study shows that the implementation of STARHS in our setting is feasible and has highlighted important features of the local HIV epidemic, such as the ongoing spread of HIV among MSM, the potential role of STIs in RIs and the vulnerability of immigrants as a new target population.

Footnotes

  • Funding: “La Marató de TV3” Foundation awarded the CEEISCAT a grant for the development of the AERI-HIV (Algoritme Estandartditzat per la detecció de Recent Infectats pel VIH) project for epidemiological research on AIDS by applying the STARHS technique (project #022010). This work was partially funded by the Direcció General de Salut Pública de la Generalitat de Catalunya and by the Fundación para la Investigación y Prevención del Sida en España (FIPSE, Madrid Spain, National AIDS Plan Secretariat of the Spanish Ministry of Health), the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III and the Spanish Network for AIDS Research (RIS; ISCIII-RETIC RD06/006). JMM was a recipient of a research grant from the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and the Conselleria de Salut de la Generalitat de Catalunya, Barcelona, Spain. The Centers for Diseases Control and Prevention (CDC) has provided the samples for the quality control programme (FDA BB-IND # 8193).

  • Competing interests: None.

  • Ethics approval: The protocol was approved by the ethics committees of all the participating centres.

  • Contributors: Project concept, design, interpretation of results: J Casabona, J Masip, N Vives, B Ortiga, A Alquézar, A Romero, M Granell, D Puente, Ma J Casado, À Jaen. Quality control programme: J Almeda. Statistical analysis: A Esteve, A Montoliu, N Ortega. Computer support: E Puchol. Management and storage of specimens: R Muñoz. Technical support: V Espurz.

    STARHS Laboratory (Microbiology Service, Hospital Universitari Germans Trias i Pujol): V González, E Martró, L Matas, V Ausina.

    Acquisition of data: D Puente, M Granell, A Romero, I Rodrigo, À Bosch, R López, E Dopico, J Ros, R Navarro, C Rovira, T Pumarola, A Casanova, E Martró, L Matas, V González, V Ausina, E Caballero, N Margall, J Farré, C Toro, M Sauca, X Ortín, M Armengual, J Ma Prats, J MaEuras, M Navarro, J Ramón Blanco, J Ma Simó, Ma C Villà, E Márquez, J M Miró, F Agüero, O Sued, M López-Dieguez, L Zamora, J M Gatell, E Ferrer, D Podzamczer, C Tural, B Clotet, E Ribera, J Altès, J Manuel Guadarrama, P Domingo, T Puig, V Soriano, C Bernal, P Barrufet, L Force, C Gutiérrez, A Ortí, G Navarro, F Segura, À Masabeu, J Vilaró, J A Iribarren, J A Oteo, B Coll, C A Villaverde, S Montull, I Garcia, J del Romero, C Rodríguez, R Sala, O Díaz, K Zaragoza, F Pujol, J Saz, M Meroño, J Becerra, R Ros, A Avellaneda, M Sité, A Rafel.

    Drafting of the manuscript: A Romero, V González, M l Granell, L Matas, A Esteve, E Martró, I Rodrigo, T Pumarola, J M Miró, A Casanova, E Ferrer, C Tural, J del Romero, C Rodríguez, E Caballero, E Ribera, J Casabona.

    Final Approval: J Casabona, J Masip, N Vives, B Ortiga, A Alquézar, A Romero, M Granell, D Puente, Ma J Casado, À Jaen, J Almeda, A Esteve, A Montoliu, N Ortega, E Puchol, R Muñoz, V Espurz, I Rodrigo, À Bosch, R López, E Dopico, J Ros, R Navarro, C Rovira, T Pumarola, A Casanova, E Martró, L Matas, V González, V Ausina, E Caballero, N Margall, J Farré, C Toro, M Sauca, X Ortín, M Armengual, J Ma Prats, J MaEuras, M Navarro, J Ramón Blanco, J Ma Simó, Ma C Villà, E Márquez, J M Miró, F Agüero, O Sued, M López-Dieguez, L Zamora, J M Gatell, E Ferrer, D Podzamczer, C Tural, B Clotet, E Ribera, J Altès, J M Guadarrama, P Domingo, T Puig, V Soriano, C Bernal, P Barrufet, L Force, C Gutiérrez, A Ortí, G Navarro, F Segura, À Masabeu, J Vilaró, J A Iribarren, J A Oteo, B Coll, C A Villaverde, S Montull, I Garcia, J del Romero, C Rodríguez, R Sala, O Díaz, K Zaragoza, F Pujol, J Saz, M Meroño, J Becerra, R Ros, A Avellaneda, M Sité, A Rafel.

  • Composition of the Standardized Algorithm for Recent HIV Infections (AERIVIH) Study Group:

    The Coordinating Center (CEEISCAT): J Casabona, J Masip, N Vives, B Ortiga, A Alquézar, A Romero, M Granell, D Puente, Ma Casado, À Jaen, J Almeda, A Esteve, A Montoliu, N Ortega, E Puchol, R Muñoz, V Espurz.

    The STARHS Laboratory (Microbiology Service, Hospital Universitari Germans Trias i Pujol): V González, E Martró, L Matas, V Ausina.

    The Peripheral Centers—Primary Health Center Laboratories: I Rodrigo (Laboratori Clínic Manso, Barcelona), À Bosch (Laboratori Intercomarcal de l’Alt Penedès, l’Anoia i el Garraf, Igualada), R López (Laboratori Clínic Bon Pastor, Barcelona), E Dopico (Laboratori Clínic l’Hospitalet de Llobregat, l’Hospitalet de Llobregat), J Ros (Laboratori Clínic Barcelonés Nord i Maresme, Badalona), R Navarro (Laboratori Clínic Cornellà de Llobregat, Cornellà de Llobregat), C Rovira (Laboratori Clínic El Maresme, Mataró). Laboratory staff: T Pumarola (Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona); A Casanova (Hospital Universitari de Bellvitge-IDIBELL, Hospitalet de Llobregat); E Martró, L Matas, V González, V Ausina (Hospital Universitari Germans Trias i Pujol, Badalona); E Caballero (Hospital Universitari Vall Hebron, Barcelona); N Margall (Hospital de la Santa Creu i Sant Pau, Barcelona); J Farré (Hospital Universitari Arnau de Vilanova, Lleida); C Toro (Hospital Carlos III, Madrid); M Sauca (Hospital de Mataró); X Ortín (Hospital de Tortosa Verge de la Cinta, Tortosa); MaJosé Armengual (Corporació Sanitària Parc Taulí, Sabadell); J Ma Prats (Hospital de Palamós); J MaEuras (Hospital General de Vic); José Ramón Blanco (Complejo San Millan-San Pedro de La Rioja); J Ma Simó (Hospital Universitari de Sant Joan de Reus); Ma C Villà (Hospital General de Granollers); E Márquez (Hospital General de l’Hospitalet, Hospitalet de Llobregat). Clinical staff: J M Miró, F Agüero, O Sued, M López-Dieguez, J M Gatell, L Zamora (Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona); E Ferrer, D Podzamczer (Hospital Universitari de Bellvitge-IDIBELL, Hospitalet de Llobregat); C Tural, B Clotet (Hospital Universitari Germans Trias i Pujol, Badalona); E Ribera (Hospital Universitari Vall Hebron, Barcelona); J Altès, J M Guadarrama (Hospital Alt Penedès, Vilafranca); P Domingo (Hospital de la Santa Creu i Sant Pau, Barcelona); T Puig (Hospital Universitari Arnau de Vilanova, Lleida); V Soriano (Hospital Carlos III, Madrid); C Bernal (Hospital Universitario San Cecilio, Granada); P Barrufet, L Force (Hospital de Mataró); C Gutiérrez (Hospital Ramón y Cajal, Madrid); A Ortí (Hospital de Tortosa Verge de la Cinta, Tortosa); G Navarro, F Segura (Corporació Sanitària Parc Taulí, Sabadell); À Masabeu (Hospital de Palamós); J Vilaró (Hospital General de Vic); J A Iribarren (Hospital de Donostia, San Sebastián); J A Oteo (Complejo San Millan-San Pedro de La Rioja); B Coll, C A Villaverde (Hospital Universitari de Sant Joan de Reus); S Montull (Hospital General de Granollers); I Garcia (Hospital General de l’Hospitalet, Hospitalet de Llobregat).

    Sexually transmitted infections clinic: J del Romero, C Rodríguez (Centro Sanitario Sandoval, Madrid).

    Community-based testing sites: R Sala (Laboratori Sabater Tobella, Barcelona); O Díaz (Servei d'Atenció i Prevenció Sociosanitària: SAPS - Creu Roja, Barcelona); K Zaragoza (Stop Sida, Barcelona); F Pujol, J Saz (Projecte dels Noms – Joves positius, Barcelona); M Meroño (Àmbit Prevenció, Barcelona); J Becerra (Associació Ciutadana Antisida de Catalunya – ACASC, Barcelona); R Ros (Centre Jove d’Anticoncepció i Sexualitat – CJAS, Barcelona); A Avellaneda, M Sité (Actua Vallès, Sabadell); A Rafel (Associació Antisida de Lleida).