HIV Drug Resistance Pattern Due to Migration in Poland

NCT ID: NCT04636736

Last Updated: 2020-11-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-01-01

Study Completion Date

2023-06-30

Brief Summary

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According to the Polish governmental statistics migration of people from Ukraine to Poland is growing and only in year 2020 have come to Poland about a quarter of a million of Ukrainian migrants. As well, more than 40% of those diagnosed with HIV infection in the European Union (EU)/European Economic Area (EEA) in 2018 were also migrants, originating from countries with generalized HIV epidemics, such as Ukraine. Antiretroviral treatment should be started, based, among others, on epidemiological data and evidence of presence of drug resistance mutations in a the population.

Detailed Description

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BACKGROUND:

According to the Polish governmental statistics during the year 2020 have come to Poland about 240 thousand of ukarinian migrants, and it is estimated that nowadays in Poland live and work about 1.2 million of people from Ukraine. In recent years substantial increases in diagnosis of HIV infected people have been reported in some countries, including Poland. At the same time 42% of those diagnosed in the EU/EEA in 2018 were migrants, defined as originating from outside of the country in which they were diagnosed. More than one-third (40%) of newly diagnosed cases due to heterosexual transmission were among migrants originating from countries with generalized HIV epidemics, such as Ukraine. Overall in the EU/ EEA, and even in some settings with decrease in newly diagnosed HIV infections in men having sex with others men (MSM), new HIV diagnoses in migrant MSM have not declined at the same rate as those who are not foreign-born. Antiretroviral treatment should be started immediately in all HIV-positive patients, regardless of origin, race, gender or sexual preferences. The choose of first-line antiretroviral regimen is based, among others, on epidemiological data and evidence of presence of drug resistance mutations in a the population.

AIM OF THE STUDY:

Due to changes in epidemiological pattern in newly diagnosed patients with HIV infection in Poland and increase in number of HIV positive patients from Ukraine we aimed to asses whether the presence of drug resistance mutations in the population of Ukrainian patients differs from the pattern of resistance of not foreign born patients with newly diagnosed HIV infection in Poland. The potential differences may have further implications on antiretroviral regimens in drug naive HIV positive patients.

MATERIAL AND METHODS:

We have designed observational, prospective study which will be performed in several clinical centers in Poland. As a part of the study we will collect epidemiological (age, gender, origin, migration data, sexual preferences) and clinical data (HIV viral load, CD4+ cells count, presence of AIDS-defining diseases, proposed combined antiretrovirat therapy (cART) regimen and the response to the treatment, Hepatitis B (HBV) and C (HCV) co-infections).

In all patients, before starting antiretroviral treatment, presence of drug resistance mutations of HIV will be assessed. The molecular diagnostics will cover mutations to the nucleotide and non-nucleotide reverse transcriptase inhibitors (NRTI and NNRTI), protease inhibitors (PI) and as well integrase inhibitors (InSTI).

Statistical evaluation will be performed in subgroups of migrants and in patients born in Poland. The distribution of continuous variables will be analysed by the Shapiro-Wilk test. The data will be expressed as the median and interquartile range (IQR). Quantitative data will be analysed using the Mann-Whitney U test or Kruskal-Wallis ANOVA when appropriate. Qualitative data will be compared using the χ² test or the Fisher exact test. A P value of \<0.05 will be considered statistically significant.

Conditions

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HIV Infections HIV-1-infection Resistant Infection

Keywords

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HIV-infection AIDS migration cART drug-resistance

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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HIV POLISH (PL)

HIV infected people with polish nationality, who most probably acquired infection in Poland

HIV drug resistance testing

Intervention Type DIAGNOSTIC_TEST

HIV drug resistance testing in people newly diagnosed in HIV in Poland

HIV MIGRANTS (M)

HIV infected people, originating from outside of Poland, where they were diagnosed with HIV infection

HIV drug resistance testing

Intervention Type DIAGNOSTIC_TEST

HIV drug resistance testing in people newly diagnosed in HIV in Poland

Interventions

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HIV drug resistance testing

HIV drug resistance testing in people newly diagnosed in HIV in Poland

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* recent diagnosis with HIV infection (\<6 months)
* no history of antiretrovirals intake (PrEP, PEP)
* age 18 years or olde
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Warsaw

OTHER

Sponsor Role lead

Responsible Party

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Andrzej Załęski

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alicja Wiercińska-Drapało, PhD

Role: STUDY_CHAIR

Department of Infectious Diseases,Tropical Diseases and Hepatology, Medical University of Warsaw

Locations

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Department of Infectious Diseases, Tropical Diseases and Hepatology, Medical University of Warsaw

Warsaw, Mazowia, Poland

Site Status

Countries

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Poland

Central Contacts

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Andrzej Zaleski, PhD

Role: CONTACT

Phone: 048600982185

Email: [email protected]

References

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Wensing AM, Calvez V, Ceccherini-Silberstein F, Charpentier C, Gunthard HF, Paredes R, Shafer RW, Richman DD. 2019 update of the drug resistance mutations in HIV-1. Top Antivir Med. 2019 Sep;27(3):111-121.

Reference Type BACKGROUND
PMID: 31634862 (View on PubMed)

Shafer RW, Rhee SY, Pillay D, Miller V, Sandstrom P, Schapiro JM, Kuritzkes DR, Bennett D. HIV-1 protease and reverse transcriptase mutations for drug resistance surveillance. AIDS. 2007 Jan 11;21(2):215-23. doi: 10.1097/QAD.0b013e328011e691.

Reference Type BACKGROUND
PMID: 17197813 (View on PubMed)

Zaleski A, Lembas A, Dyda T, Siwak E, Osinska J, Suchacz M, Stempkowska-Rejek J, Strycharz M, Orzechowska J, Wiercinska-Drapalo A. Changes in Primary HIV-1 Drug Resistance Due to War Migration from Eastern Europe. J Immigr Minor Health. 2024 Feb;26(1):15-22. doi: 10.1007/s10903-023-01559-1. Epub 2023 Nov 16.

Reference Type DERIVED
PMID: 37973713 (View on PubMed)

Other Identifiers

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HIVresistancePL

Identifier Type: -

Identifier Source: org_study_id