{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:46:18Z","timestamp":1790401578560,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rates of syphilis in the United States have more than doubled over the last several decades, largely among men who have sex with men (MSM). Our study characterizes a cluster of neurosyphilis cases among people with human immunodeficiency virus 1 (HIV-1) in Vermont in 2017\u20132018.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Vermont Department of Health disease intervention specialists conduct interviews with newly diagnosed HIV-1 cases and pursue sexual networking analyses. Phylogenetic and network analyses of available Vermont HIV-1 polymerase (pol) sequences identified clusters of infection. Fishers-exact and independent t-tests were used to compare people with HIV-1 within or outside an identified cluster.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 1 January 2017 and 31 December 2018, 38 residents were diagnosed with HIV-1 infection. The mean age was 35.5 years, 79% were male and 82% were White. Risk factors for HIV-1 included MSM status (79%) and methamphetamine use (21%). Eighteen cases (49%) had HIV-1 viral loads (VLs) &amp;gt;100 000 copies\/mL and 47% had CD4 cell counts &amp;lt;200\/mm3. Eleven of the 38 (29%) had positive syphilis serology, including four (36%) with neurosyphilis. Sexual networking analysis revealed a ten-person cluster with higher VLs at diagnosis (90% with VLs &amp;gt; 100 000 copies\/mL vs 33%, P = 0.015). Phylogenetic analysis of pol sequences showed a cluster of 14 cases with sequences that shared 98%\u2013100% HIV-1 nucleotide identity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This investigation of newly infected HIV-1 cases in Vermont led to identification of a cluster that appeared more likely to have advanced HIV-1 disease and neurosyphilis, supported by phylogenetic and network analyses.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1834","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T05:02:34Z","timestamp":1607144554000},"page":"e3244-e3249","source":"Crossref","is-referenced-by-count":1,"title":["Identification of a Human Immunodeficiency Virus Type 1 and Neurosyphilis Cluster in Vermont"],"prefix":"10.1093","volume":"73","author":[{"given":"Devika","family":"Singh","sequence":"first","affiliation":[{"name":"Division of Infectious Disease, Department of Medicine, University of Vermont Medical Center, Burlington, Vermont, USA"},{"name":"Department of Pediatrics, Larner College of Medicine, Burlington, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M","family":"Switzer","sequence":"additional","affiliation":[{"name":"Laboratory Branch, Division of HIV\/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Belcher","sequence":"additional","affiliation":[{"name":"Vermont Department of Health, Burlington, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Daltry","sequence":"additional","affiliation":[{"name":"Vermont Department of Health, Burlington, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S","family":"Read","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Larner College of Medicine, Burlington, Vermont, USA"},{"name":"Vermont Department of Health, Burlington, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"2021110300265182800_CIT0001","volume-title":"Sexually transmitted disease surveillance 2014","author":"Centers for Disease Control and Prevention."},{"key":"2021110300265182800_CIT0002","first-page":"402","article-title":"Primary and secondary syphilis\u2014United States, 2005-2013","volume":"63","author":"Patton","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021110300265182800_CIT0003","author":"Centers for Disease Control and 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