HIV

Randomized-trial data on the risks and benefits of antiretroviral therapy (ART) as compared with zidovudine and single-dose nevirapine to prevent transmission of the human immunodeficiency virus (HIV) in HIV-infected pregnant women with high CD4 counts are lacking.

Data from randomized trials are lacking on the benefits and risks of initiating antiretroviral therapy in patients with asymptomatic human immunodeficiency virus (HIV) infection who have a CD4+ count of more than 350 cells per cubic millimeter.

Progressive immune dysfunction and the acquired immunodeficiency syndrome (AIDS) develop in most persons with untreated infection with human immunodeficiency virus type 1 (HIV-1) but in only approximately 20 to 30% of persons infected with HIV type 2 (HIV-2); among persons infected with both types, the natural history of disease progression is poorly understood.

Antiretroviral preexposure prophylaxis is a promising approach for preventing human immunodeficiency virus type 1 (HIV-1) infection in heterosexual populations.

The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain.

There is considerable genetic diversity among viruses of different subtypes (designated A to J) in the major group of human immunodeficiency virus type 1 (HIV-1), the form of HIV that is dominant in the global epidemic. If available, HIV-1 sequences pre-dating the recognition of AIDS could be crucial in defining the time of origin and the subsequent evolution of these viruses in humans. The oldest known case of HIV-1 infection was reported to be that of a sailor from Manchester who died of an AIDS-like illness in 1959; however, the authenticity of this case has not been confirmed. Genetic analysis of sequences from clinical materials obtained from 1971 to 1976 from members of a Norwegian family infected earlier than 1971 showed that they carried viruses of the HIV-1 outlier group, a variant form that is mainly restricted to West Africa. Here we report the amplification and characterization of viral sequences from a 1959 African plasma sample that was previously found to be HIV-1 seropositive. Multiple phylogenetic analyses not only authenticate this case as the oldest known HIV-1 infection, but also place its viral sequence near the ancestral node of subtypes B and D in the major group, indicating that these HIV-1 subtypes, and perhaps all major-group viruses, may have evolved from a single introduction into the African population not long before 1959.

Demontès M, Eymard Duvernay S, Allavena C, et al.

AbstractObjectiveWe assessed prevalence of multimorbidity (MM) according to year of HIV diagnosis in people living with HIV (PLHIV) of geriatric age.DesignCross-sectional study of MM in PLHIV over 70 years old from the Dat’AIDS French multicentric cohort. MM was defined as at least three co-existent morbidities of either high blood pressure (HBP), diabetes mellitus, osteoporosis, non-AIDS cancer, chronic renal failure, cardio and cerebrovascular disease, obesity, cachexia or hypercholesterolemia. Logistic regression models evaluated the association between MM and calendar periods of HIV-diagnosis (1983-1996, 1997-2006 and 2007-2018). The secondary analysis evaluated MM as a continuous outcome and a sensitivity analysis excluded PLHIV with nadir TCD4 cells < 200 cells/mm3.ResultsBetween January 2017 and September 2018, 2476 PLHIV were included. Median age was 73 years old, 75% were men, median CD4 was 578 cells/mL, and 94% had controlled viremia. MM prevalence was 71%. HBP and hypercholesterolemia were the most prevalent comorbidities. After adjustment for age, gender, smoking status, HCV, HBV co-infection, group of exposure, nadir CD4, and CD4:CD8 ratio and last CD4 levels, calendar periods of diagnosis was not associated with MM (p=0.169). MM was associated with older age, CD4/CD8 ratio < 0.8 and nadir CD4 cells < 200 cells/mL. Similar results were found with secondary and sensitivity analyses.ConclusionMM prevalence was high and increased with age, low CD4/CD8 ratio and nadir CD4 cells < 200mm3 but was not associated with calendar periods of HIV-diagnosis. Known duration of HIV-diagnosis does not seem a criterion for selecting elderly PLHIV at risk of MM.

Merchante N, Saroli Palumbo C, Mazzola G, et al.

AbstractBackgroundHuman immunodeficiency virus (HIV)-infected individuals are at increased risk of cirrhosis and esophageal varices. Baveno VI criteria, based on liver stiffness measurement (LSM) and platelet count, have been proposed to avoid unnecessary esophagogastroduodenoscopy (EGD) screening for esophageal varices needing treatment (EVNT). This approach has not been validated in HIV-infected patients.MethodsHIV-infected patients from eight prospective cohorts were included if they fulfilled the following criteria: 1) compensated advanced chronic liver disease (LSM >10 kPa); 2) availability of EGD within 6 months of reliable LSM. Baveno VI (LSM 150,000), expanded Baveno VI (LSM 110,000) and HEPAVIR criteria (LSM 110,000 and LSM

Robertson M, Braunstein S, Hoover D, et al.

AbstractBackgroundWe estimated the time from HIV seroconversion to ART initiation in a population-based sample of people diagnosed with HIV during an era of expanding HIV testing and treatment efforts.MethodsApplying CD4 depletion model parameters from seroconverter cohort data to our population-based sample, we related the square root of the first pre-treatment CD4 count to time of serconversion though a linear mixed model and estimated the time from seroconversion to diagnosis and ART initiation.ResultsAmong 28,162 people diagnosed with HIV during 2006-2015, 89% initiated ART by June 2017. The median CD4 count at diagnosis increased from 326 (Interquartile range (IQR):132-504) to 390 (IQR:216-571) cells/µL from 2006-2015. The median time from estimated seroconversion to ART initiation decreased by 42% from 6.4 years (IQR:3.3-11.4) in 2006 to 3.7 years (IQR:0.5-8.3) in 2015. Contributing to the reduction in time to ART initiation, the time from estimated seroconversion to diagnosis decreased by 28%, from a median of 4.6 years (IQR:0.5-10.5) to 3.3 years (IQR:0-8.1) from 2006-2015, and the time from diagnosis to ART initiation reduced by 60%, from a median of 0.5 years (IQR:0.2-2.1) to 0.2 years (IQR:0.1-0.3) from 2006-2015.ConclusionsThe estimated time from seroconversion to ART initiation was reduced in tandem with expanded HIV testing and treatment efforts. While the time from diagnosis to ART initiation decreased to a median of 0.2 years, the time from seroconversion to diagnosis was 3.3 years among people diagnosed in 2015, highlighting the need for more effective strategies for earlier HIV diagnosis.

Darcis, G., Maes, N., Pasternak, A. O., Sauvage, A.-S., Frippiat, F., Meuris, C., Uurlings, F., Lecomte, M., Leonard, P., Elmoussaoui, M., Fombellida, K., Vaira, D., Moutschen, M.

Background: HIV persistence despite therapy contributes to chronic immune activation and inflammation, increasing the risk of aging-associated events in HIV-infected individuals.Objectives: To better understand the complex link between clinical and treatment features and HIV persistence despite therapy.Methods: 11045 samples from 1160 individuals under combination antiretroviral therapy (cART) with unquantifiable viral load (VL, limit of quantification: 20 copies/ml) were categorized as detectable or undetectable depending on the detection of a PCR signal using a commercially available assay. Generalized estimating equations regression was used to model viral load detectability and to assess determinants of residual viremia (RV: VL detected below 20 copies/ml) despite therapy.Results: High VL zenith was associated with a higher probability to have a detectable viremia under cART. Conversely, the probability to have a detectable viral load below 20 copies/ml decreased with time under therapy. Of therapy regimens, protease inhibitor (PI)-based cART was associated with a significantly higher probability of detectable RV compared to non-nucleoside transcriptase inhibitor- or integrase inhibitor-based cART.Conclusions: PI-based treatment regimen is highly associated with an increased frequency of RV, supporting the previous evidence suggesting that PI-based cART regimens could favor ongoing viral replication in some individuals.…

Angelovich, Thomas A.; Trevillyan, Janine M.; Hoy, Jennifer F.; Wong, Michelle E.; Agius, Paul A.; Hearps, Anna C.; Jaworowski, Anthony

Objective: People living with HIV have an increased risk of cardiovascular disease (CVD) despite effective antiretroviral therapy (ART). Monocytes play a key role in the early stages of atherosclerosis-driven CVD by forming lipid-laden foam cells within artery walls. HIV infection potentiates foam cell formation ex vivo, but the mechanisms contributing to this are not known. Methods: We investigated the atherosclerosis-promoting potential of monocytes from 39 virologically suppressed men living with HIV (MLHIV) on ART and no evidence of CVD, and 25 HIV-uninfected controls of comparable age, sex, smoking status and CVD risk. Results: Despite absence of clinical atherosclerosis in both MLHIV and uninfected cohorts (evidenced by a carotid intima-media thickness of 0.6 mm for both groups; p = 0.254), monocytes from MLHIV showed increased potential to form atherosclerosis-promoting foam cells compared to controls in an ex vivo assay (36.6% vs 27.6% respectively, p = 0.003). Consistent with observations of persistent inflammation and immune/endothelial activation in ART-treated HIV infection, levels of soluble TNF receptor II, CXCL10 and soluble VCAM-1 were elevated in MLHIV (p≤0.005 for all), but were not significantly associated with foam cell formation. Foam cell formation was associated with an impaired ability of monocytes to undergo reverse transmigration, and a reduced ability to efflux cholesterol ex vivo (p …

Singh K, Lewin S.

Abstract…

Leumi S, Bigna J, Amougou M, et al.

AbstractBackgroundThis systematic review and meta-analysis was conducted to estimate the prevalence and burden of HBV infection in PLWH at global, regional, and national levels.MethodsWe searched of PubMed, Excerpta Medica Database, Web of Science, and Global Index Medicus to identify studies published between January 01, 1990 and December 31st, 2017. HBV infection (HBs antigen) had to be diagnosed with serological assays. Random-effect models meta-analysis served to pool data.ResultsWe included 358 studies (834,544 PLWH from 87 countries). The pooled prevalence of HBV infection was 8.4% (95% confidence interval: 7.9-8.8); among which 26.8% (22.0-31.9) were positive to HBe antigen. The HBV prevalence was different according to UNAIDS regions: West & Central Africa: 12.4% (11.0-13.8), Middle East & North Africa: 9.9% (6.0-14.6), Asia & the Pacific: 9.8% (8.7-11.0), Eastern & Southern Africa: 7.4% (6.4-8.4), Western and Central Europe & North America: 6.0% (5.5-6.7), and Latin America & the Caribbean: 5.1% (4.2-6.2); p < 0.0001. The prevalence decreased from 10.4% in low to 6.6% in very high developed countries; p < 0.0001 and increased from 7.3% in countries with HIV prevalence ≤ 1% to 9.7% in countries with HIV prevalence > 1%; p < 0.0001. Globally, we estimated that there were roughly 3,136,500 (95%CI: 2,95,2000-3,284,100) cases of HBV in PLWH; with 73.8% of estimated regional cases from sub-Saharan Africa and 17.1% from Asia & the Pacific.ConclusionsThis study suggests a high burden of HBV infection in PLWH, with disparities according to regions, level of development, and country HIV prevalence.

Junyan Han, Weiwei Mu, Hongxin Zhao, Yu Hao, Chuan Song, Haiwei Zhou, Xin Sun, Guoli Li, Guorui Dai, Yu Zhang, Fujie Zhang, Hui Zeng

Mbunkah H, Bertagnolio S, Hamers R, et al.

AbstractBackgroundThe presence of high-abundance drug-resistant HIV-1 jeopardizes the success of antiretroviral therapy (ART). Despite numerous investigations, the clinical impact of low-abundance drug-resistant HIV-1 variants (LA-DRVs) present at levels

Roger Ying, Lelisa Fekadu, Bruce R. Schackman, Stéphane Verguet

Tropical Medicine &International Health, Volume 0, Issue ja, -Not available-.

Peebles, Kathryn; van der Straten, Ariane; Palanee-Phillips, Thesla; Reddy, Krishnaveni; Hillier, Sharon L.; Hendrix, Craig W.; Harkoo, Ishana; Mirembe, Brenda Gati; Jeenarain, Nitesha; Baeten, Jared M.; Brown, Elizabeth R.

Objectives. To describe receptive anal intercourse (RAI) behaviors and correlates in a cohort of sub-Saharan African women, evaluate the association of RAI with HIV-1 risk, and evaluate whether the HIV-1 prevention efficacy of a dapivirine-containing vaginal ring differs among women who reported RAI. Design. Secondary analysis of the MTN-020/ASPIRE trial, a randomized, double-blind, placebo-controlled trial evaluating a dapivirine-containing vaginal ring for HIV-1 prevention. Methods. At enrollment and month three, women reported RAI in the prior three months in audio computer-assisted self-interviews. We evaluated associations between RAI and participant characteristics with chi-square and t-tests adjusted for study site. Cox proportional hazards models stratified by study site tested the association of RAI with HIV-1 acquisition and effect modification by RAI. Results. Nineteen percent of women reported any RAI at enrollment and/or month 3, with a median of 2 (IQR: 1, 4) RAI acts in the prior three months, accounting for 1.5% of total sex acts. RAI prevalence was higher among women with lower educational attainment and those reporting transactional sex. In adjusted models, RAI was not associated with HIV-1 acquisition (aHR: 0.93, 95% CI: 0.57, 1.54). The ring reduced HIV-1 risk by 27% (95% CI: -5, 49) among women reporting no RAI and by 18% (95% CI: -57, 57) among women reporting any RAI (interaction p-value=0.77). Conclusions. RAI was modestly infrequent and was not associated with reduced HIV-1 protection from the ring, suggesting that, in populations with rates of RAI similar to this cohort, RAI may not appreciably reduce the population-level impact of the dapivirine vaginal ring. Corresponding author: Kathryn Peebles, MPH University of Washington Department of Epidemiology 1959 NE Pacific St Health Sciences Bldg, F-262 Box 357236 Seattle, WA 98195 Email: kpeebles@uw.edu Telephone: +1 (360) 941-5510 Conflicts of interest: The authors declare no conflicts of interest. Funding: The Microbicide Trials Network (MTN) is funded by National Institute of Allergy and Infectious Disease (UM1AI068633, UM1AI068615, and UM1AI106707), with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Institute of Mental Health, all components of the US National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Dirajlal-Fargo S, Albar Z, Bowman E, et al.

AbstractIntroductionThe risk of cardiovascular disease (CVD) and its mechanisms in children living with perinatally acquired HIV (PHIV) in sub-Saharan Africa has been understudied.MethodsMean common carotid artery intima-media thickness (IMT) and pulse wave velocity (PWV) were evaluated in 101 PHIV and 96 HIV negative children (HIV-). PHIVs were on ART, with HIV-1 RNA level ≤400 copies/mL. We measured plasma and cellular markers of monocyte activation, T-cell activation, oxidized lipids and gut integrity.ResultsOverall median (Q1; Q3) age was 13 years (11; 15) and 52% were females. Groups were similar by age, sex and BMI. Median ART duration was 10 years (8; 11). PHIVs had higher waist-hip ratio, triglycerides, and insulin resistance (p≤ 0.03). Median IMT was slightly thicker in PHIVs compared to HIV- children (1.05 mm vs 1.02 mm for mean IMT and 1.25 vs 1.21 mm for max IMT; p

Abstract Background Cytomegalovirus infection dramatically decreased with the introduction of antiretroviral therapy. Whether incidence, clinical characteristics and prognosis of cytomegalovirus in HIV infected patients, has changed over time is. scarcely known. Methods Retrospective single-center study. Patients included in this study were all HIV infected patients that went to our center for any disease, and were diagnosed with cytomegalovirus, during the period 2004–2015. epidemiological, clinical and laboratory patients variables were collected in a clinical database. Clinical characteristics, incidence of cytomegalovirus and predictors of mortality during the study were assessed. Results were considered statistically significant when p 

Abstract Background Anemia is a common problem in HIV (human immunodeficiency virus) infected patients, and is associated with decreased functional capacity and quality of life. Ethiopia is one of the countries which has expanded highly active antiretroviral treatment (HAART) over the past years. The effect of HAART on anemia among HIV remains inconsistent and inconclusive, particularly in children. This study thus aimed to synthesize the prevalence of anemia among HIV infected Ethiopian children and its association with HAART initiation. Methods MEDLINE/PubMed, EMBASE, PsycINFO, Web of Science and Google scholar were used to identify 12 eligible studies reporting an association between anemia and HIV using a priori set criteria. PRISMA guideline was used to systematically review and meta-analysis these studies. Details of sample size, magnitude of effect sizes, including odds ratio (OR) and standard errors were extracted. Random-effects model was used to calculate the pooled estimates using STATA/SE version-14. I2 and meta-bias statistics assessed heterogeneity and publication bias of the included studies. Sub-group analyses, based on study designs, were also carried out. Results In Ethiopia, the overall prevalence of anemia in HIV infected children was 22.3% (95% CI: 18.5–26.0%). The OR of anemia-HIV/AIDS comorbidity was 0.4 (95% CI, 0.2–0.5) in HAART initiated children as compared to non-initiated counterparts. Meta-bias and funnel plot detected no publication bias. Conclusion On aggregate, anemia is a common comorbidity in pediatric HIV patients. HAART was significantly associated with a reduced anemia-HIV/AIDS comorbidity. Prompt start of HAART might help decreasing the prevalence of anemia and its subsequent complications.…

Anderson J, Khoury G, Fromentin R, et al.

AbstractBackgroundIdentifying where human immunodeficiency virus (HIV) persists in people living with HIV and receiving antiretroviral therapy is critical to develop cure strategies. We assessed the relationship of HIV persistence to expression of chemokine receptors and their chemokines in blood (n = 48) and in rectal (n = 20) and lymph node (LN; n = 8) tissue collected from people living with HIV who were receiving suppressive antiretroviral therapy.MethodsCell-associated integrated HIV DNA, unspliced HIV RNA, and chemokine messenger RNA were quantified by quantitative polymerase chain reaction. Chemokine receptor expression on CD4+ T cells was determined using flow cytometry.ResultsIntegrated HIV DNA levels in CD4+ T cells, CCR6+CXCR3+ memory CD4+ T-cell frequency, and CCL20 expression (ligand for CCR6) were highest in rectal tissue, where HIV-infected CCR6+ T cells accounted for nearly all infected cells (median, 89.7%). Conversely in LN tissue, CCR6+ T cells were infrequent, and there was a statistically significant association of cell-associated HIV DNA and RNA with CCL19, CCL21, and CXCL13 chemokines.ConclusionsHIV-infected CCR6+ CD4+ T cells accounted for the majority of infected cells in rectal tissue. The different relationships between HIV persistence and T-cell subsets and chemokines in rectal and LN tissue suggest that different tissue-specific strategies may be required to eliminate HIV persistence and that assessment of biomarkers for HIV persistence may not be generalizable between blood and other tissues.

Krebs, Emanuel; Zang, Xiao; Enns, Benjamin; Min, Jeong E.; Behrends, Czarina N.; del Rio, Carlos; Dombrowski, Julia C.; Feaster, Daniel J.; Gebo, Kelly A.; Golden, Matthew; Marshall, Brandon D.L.; Metsch, Lisa R.; Schackman, Bruce R.; Shoptaw, Steven; Strathdee, Steffanie A.; Nosyk, Bohdan; On behalf of the localized economic modeling study group.

Objective: Effective interventions to reduce the public health burden of HIV/AIDS can vary in their ability to deliver value at different levels of scale and in different epidemiological contexts. Our objective was to determine the cost-effectiveness of HIV treatment and prevention interventions implemented at previously documented scales of delivery in six US cities with diverse HIV microepidemics. Design: Dynamic HIV transmission model-based cost-effectiveness analysis. Methods: We identified and estimated previously documented scale of delivery and costs for 16 evidence-based interventions from the US CDC's Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. Using a model calibrated for Atlanta, Baltimore, Los Angeles, Miami, New York City and Seattle, we estimated averted HIV infections, quality-adjusted life years (QALY) gained and incremental cost-effectiveness ratios (healthcare perspective; 3% discount rate, 2018$US), for each intervention and city (10-year implementation) compared with the status quo over a 20-year time horizon. Results: Increased HIV testing was cost-saving or cost-effective across cities. Targeted preexposure prophylaxis for high-risk MSM was cost-saving in Miami and cost-effective in Atlanta ($6123/QALY), Baltimore ($18 333/QALY) and Los Angeles ($86 117/QALY). Interventions designed to improve antiretroviral therapy initiation provided greater value than other treatment engagement interventions. No single intervention was projected to reduce HIV incidence by more than 10.1% in any city. Conclusion: Combination implementation strategies should be tailored to local epidemiological contexts to provide the most value. Complementary strategies addressing factors hindering access to HIV care will be necessary to meet targets for HIV elimination in the United States. Corresponding to: Bohdan Nosyk, PhD, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 613-1081 Burrard Street. Vancouver, BC, Canada V6Z 1Y6. Tel: +1 604 806 8649; e-mail: bnosyk@cfenet.ubc.ca Received 28 August, 2019 Revised 12 November, 2019 Accepted 15 November, 2019 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.AIDSonline.com). Copyright © 2019 Wolters Kluwer Health, Inc.

Young, Peter W.; Zielinski-Gutierrez, Emily; Wamicwe, Joyce; Mukui, Irene; Kim, Andrea A.; Waruru, Anthony; Zeh, Clement; Kretzschmar, Mirjam E.; De Cock, Kevin M.

Objective: To compare alternative methods of adjusting self-reported knowledge of HIV-positive status and antiretroviral (ARV) therapy use based on undetectable viral load (UVL) and ARV detection in blood. Design: Post hoc analysis of nationally representative household survey to compare alternative biomarker-based adjustments to population HIV indicators. Methods: We reclassified HIV-positive participants aged 15–64 years in the 2012 Kenya AIDS Indicator Survey (KAIS) that were unaware of their HIV-positive status by self-report as aware and on antiretroviral treatment if either ARVs were detected or viral load was undetectable (…

Kakkar, Fatima; Lee, Terry; Hawkes, Michael T.; Brophy, Jason; Lindy, Samson; Singer, Joel; Dieumegard, Hinatea; Sauve, Laura; Alimenti, Ariane; Vaudry, Wendy; Seigel, Sandra; Tan, Ben; Karatzios, Christos; Lamarre, Valerie; Read, Stanley; Soudeyns, Hugo; Bitnun, Ari; EPIC4 Study Group

Objectives: The objective of this study was to determine the time to, and durability of, viral suppression, among Canadian children living with HIV after initiation of combination antiretroviral therapy (cART). Design: Prospective, multicenter Canadian cohort study (Early Pediatric Initiation Canada Child Cure Cohort), using both prospective and retrospectively collected data. Methods: Kaplan–Meir survival estimates with Cox regression were used to determine the time to and risk factors for viral suppression, defined as two consecutive undetectable viral loads (…

McCrary, Andrew W.; Nyandiko, Winstone; Ellis, Alicia M.; Chakraborty, Hrishikesh; Muehlbauer, Michael J.; Koech, Myra; Daud, Ibrahim; Birgen, Elcy; Thielman, Nathan M.; Kisslo, Joseph A.; Barker, Piers C.A.; Bloomfield, Gerald S.

Objective: To define the prevalence of early cardiac dysfunction in children and young adults with perinatally acquired HIV and predictors of cardiac function. Design: Cross-sectional design. Methods: Early cardiac dysfunction was defined as left ventricular (LV) global longitudinal strain z-score less than −2 or myocardial performance index at least 0.5 with normal LV ejection fraction. Regression models were fitted to assess the relationship between measures of cardiac function and HIV RNA levels, clinical variables, and markers of inflammation. Results: Six-hundred and forty-three individuals (mean age 14.1 ± 5.2 years) were enrolled. The average time on combination antiretroviral treatment was 6.8 ± 3.6 years. Nearly 28% of individuals met criteria for early cardiac dysfunction. Individuals with early cardiac dysfunction were older (15.3 vs. 13.5 years, P …

Xia, Qiang; Wertheim, Joel O.; Braunstein, Sarah L.; Misra, Kavita; Udeagu, Chi-Chi; Torian, Lucia V.

Background: To develop a predictive model to prioritize persons with a transmissible HIV viral load for transmission-reduction interventions. Methods: New York City (NYC) HIV molecular surveillance data from 2010 to 2013 were used to build a model to predict the probability that the partial pol gene of the virus of a person with a transmissible HIV viral load (>1500 copies/ml) would be genetically similar to that of a person with a new HIV infection (diagnosis at stage 0 or 1 according to the revised Centers for Disease Control and Prevention classification system). Data from 2013 to 2016 were then used to validate the model and compare it with five other selection strategies that can be used to prioritize persons for transmission-reduction interventions. Results: A total of 10 609 persons living with HIV (PLWH) were included in the development dataset, and 8257 were included in the validation dataset. Among the six selection strategies, the predictive model had the highest area under the receiver operating characteristic curve (AUC) [0.86, 95% confidence interval (CI) 0.84--0.88), followed by the ‘Young MSM’ (0.79, 95% CI 0.77--0.82), ‘MSM with high viral loads’ (0.74, 95% CI 0.72--0.76), ‘Random sample of MSM’ (0.73, 95% CI 0.71--0.76), ‘Persons with high viral loads’ (0.56, 95% CI 0.54--0.59), and ‘Random sample’ (0.50, 95% CI 0.48--0.53) strategies. Conclusions: Jurisdictions should consider applying predictive modeling to prioritize persons with a transmissible viral load for transmission-reduction interventions and to evaluate its feasibility and effectiveness. Correspondence to Qiang Xia, MD, MPH, HIV Epidemiology and Field Services Program, Bureau of HIV Prevention and Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY 11101, USA. E-mail: qxia@health.nyc.gov Received 29 August, 2019 Revised 30 October, 2019 Accepted 31 October, 2019 Copyright © 2019 Wolters Kluwer Health, Inc.