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Zhong X, Yuan D, Fan SF, Liu Y, Su L, He SJ, Liang S, Yang Y. Molecular network analysis of 308 newly diagnosed HIV infection and 210 ART failure patients from rural counties in Sichuan. PLoS One 2024; 19:e0298324. [PMID: 38363761 PMCID: PMC10871515 DOI: 10.1371/journal.pone.0298324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 01/18/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Few studies on molecular epidemiology have studied people with newly diagnosed HIV infection and ART Failure Patients at the same time in rural China. With more serious HIV epidemic than in other provinces in China, Sichuan is an area suitable for this study. OBJECTIVE To analyze the characteristics of HIV-1 molecular networks and factors related to network entry among newly diagnosed HIV infection and ART Failure Patients in three county-level cities (A, B, C) in Sichuan Province, to provide scientific basis for accurate prevention and control. METHODS Nested PCR amplification method was used to amplify HIV-1 pol gene region of 530 blood samples, Sequencer 4.9 was used to edit, clean and splice the gene sequence, Bioedit correction, Fastree 2.1.8 and Figtree 1.4.2 to construct evolutionary tree and determine genotype. HyPhy2.2.4 and Cytoscape 3.6.1 software were used to construct molecular network. Logistic regression analysis was applied. RESULTS 523(98.68%) pol sequences were obtained, and a total of 518 valid sequences with basic information came into the final analyses. A total of 6 genotypes were detected, namely CRF01_AE (320,61.78%), CRF07_BC (149,28.76%), B (30,5.79%), CRF08_BC (11, 2.12%), CRF55_01B (6, 1.16%) and C (2, 0.39%). 186 of 518(35.91%) sequences entered the network at a genetic distance of 0.8%, forming 42 propagation clusters. "High-risk transmitters"(connected with two and more) accounted for 21.62%. Logistic regression showed that≥50 years old (OR = 2.474) were more risky than 18-49 years old, CRF07_BC sub-type (OR = 0.174) were less risky than CRF01_AE sub-type, B sub-type (OR = 6.698) is higher risky than CRF01_AE sub-type, and District B (OR = 0.077) less risky than that of A city. CONCLUSION The sources of HIV infection in rural Sichuan are diversified and complicated. The prevention and control of HIV infection in Sichuan Province should focus on strengthening the long-term dynamic detection of elderly population, B strain sub-type, and in City A.
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Affiliation(s)
- Xia Zhong
- School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dan Yuan
- Institute of HIV/AIDS prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Shuang feng Fan
- Department of HIV/AIDS prevention, Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Yang Liu
- Department of HIV/AIDS prevention, Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Ling Su
- Institute of HIV/AIDS prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Shi Jiao He
- Department of HIV/AIDS prevention, Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Shu Liang
- Institute of HIV/AIDS prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yi Yang
- School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Fan Q, Zhang J, Luo M, Feng Y, Ge R, Yan Y, Zhong P, Ding X, Xia Y, Guo Z, Pan X, Chai C. Molecular Genetics and Epidemiological Characteristics of HIV-1 Epidemic Strains in Various Sexual Risk Behaviour Groups in Developed Eastern China, 2017-2020. Emerg Microbes Infect 2022; 11:2326-2339. [PMID: 36032035 PMCID: PMC9542350 DOI: 10.1080/22221751.2022.2119167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Qin Fan
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
| | - Jiafeng Zhang
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
| | - Mingyu Luo
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
| | - Yi Feng
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, People’s Republic of China
| | - Rui Ge
- Division of AIDS/TB Prevention and Control, Jiaxing Municipal Center for Disease Control and Prevention, Jiaxing 314050, People’s Republic of China
| | - Yong Yan
- Division of AIDS/TB Prevention and Control, Jiaxing Municipal Center for Disease Control and Prevention, Jiaxing 314050, People’s Republic of China
| | - Ping Zhong
- Department of AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200051, People’s Republic of China
| | - Xiaobei Ding
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
| | - Yan Xia
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
| | - Zhihong Guo
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
| | - Xiaohong Pan
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
| | - Chengliang Chai
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
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Ding X, Chaillon A, Pan X, Zhang J, Zhong P, He L, Chen W, Fan Q, Jiang J, Luo M, Xia Y, Guo Z, Smith DM. Characterizing genetic transmission networks among newly diagnosed HIV-1 infected individuals in eastern China: 2012-2016. PLoS One 2022; 17:e0269973. [PMID: 35709166 PMCID: PMC9202869 DOI: 10.1371/journal.pone.0269973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/01/2022] [Indexed: 11/19/2022] Open
Abstract
We aimed to elucidate the characteristics of HIV molecular epidemiology and identify transmission hubs in eastern China using genetic transmission network and lineage analyses. HIV-TRACE was used to infer putative relationships. Across the range of epidemiologically-plausible genetic distance (GD) thresholds (0.1-2.0%), a sensitivity analysis was performed to determine the optimal threshold, generating the maximum number of transmission clusters and providing reliable resolution without merging different small clusters into a single large cluster. Characteristics of genetically linked individuals were analyzed using logistic regression. Assortativity (shared characteristics) analysis was performed to infer shared attributes between putative partners. 1,993 persons living with HIV-1 were enrolled. The determined GD thresholds within subtypes CRF07_BC, CRF01_AE, and B were 0.5%, 1.2%, and 1.7%, respectively, and 826 of 1,993 (41.4%) sequences were linked with at least one other sequence, forming 188 transmission clusters of 2-80 sequences. Clustering rates for the main subtypes CRF01_AE, CRF07_BC, and B were 50.9% (523/1027), 34.2% (256/749), and 32.1% (25/78), respectively. Median cluster sizes of these subtypes were 2 (2-52, n = 523), 2 (2-80, n = 256), and 3 (2-6, n = 25), respectively. Subtypes in individuals diagnosed and residing in Hangzhou city (OR = 1.423, 95% CI: 1.168-1.734) and men who have sex with men (MSM) were more likely to cluster. Assortativity analysis revealed individuals were more likely to be genetically linked to individuals from the same age group (AIage = 0.090, P<0.001) and the same area of residency in Zhejiang (AIcity = 0.078, P<0.001). Additionally, students living with HIV were more likely to be linked with students than show a random distribution (AI student = 0.740, P<0.01). These results highlight the importance of Hangzhou City in the regional epidemic and show that MSM comprise the population rapidly transmitting HIV in Zhejiang Province. We also provide a molecular epidemiology framework for improving our understanding of HIV transmission dynamics in eastern China.
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Affiliation(s)
- Xiaobei Ding
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Antoine Chaillon
- Department of Medicine, University of California, San Diego, California, United States of America
| | - Xiaohong Pan
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Jiafeng Zhang
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Ping Zhong
- Department of AIDS and STD Control and Prevention, Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China
| | - Lin He
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Wanjun Chen
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Qin Fan
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Jun Jiang
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Mingyu Luo
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Yan Xia
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Zhihong Guo
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Davey M. Smith
- Department of Medicine, University of California, San Diego, California, United States of America
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Chen X, Qin C, Chen R, Huang Y, Xu Y, Tang Q, Liang X, Peng B, Shao Y, Yang Y, Chen J, Wang X, Wen L, Liang B, Ye L, Qin X, Jiang J, Liang H. Epidemiological profile and molecular genetic characterization of HIV-1 among female sex workers and elderly male clients in Guangxi, China. Emerg Microbes Infect 2021; 10:384-395. [PMID: 33560929 PMCID: PMC7935120 DOI: 10.1080/22221751.2021.1888659] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The HIV/AIDS prevalence in female sex workers (FSWs) and elderly male clients is increasing in Guangxi, China, but the transmission relationship between them remains unclear. This study aims to illuminate the transmission network between FSWs and elderly male clients using molecular epidemiological analyses. Phylogenetic analysis indicated that CRF01_AE was the dominant strain, followed by CRF07_BC and CRF08_BC in both groups. Multivariate logistic regression analysis indicated that viral loads of 50 to 1000 copies/mL, immunological treatment failure and CRF07_BC were risk factors for entering the transmission network. Transmission network analysis showed that CRF07_BC tended to form large clusters, whereas CRF01_AE tended to form multiple but small clusters. Two groups of 11 FSWs and 169 clients were intricately intertwined. Spatial analysis demonstrated the formation of hotspots and clusters of transmission sharing regional differences. In conclusion, our study provides direct genetic evidence of transmission linkages between FSWs and elderly male clients. Although the CRF01_AE subtype was still the predominant subtype in the region, the higher degree and larger clusters found in CRF07_BC illustrate a rapid and intensive uptrend, which is expected to increase its prevalence in the region in the future.
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Affiliation(s)
- Xiu Chen
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Chunwei Qin
- Guigang Center for Disease Control and Prevention, Guigang, 537100, Guangxi, People's Republic of China
| | - Rongfeng Chen
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Yunxuan Huang
- Guigang Center for Disease Control and Prevention, Guigang, 537100, Guangxi, People's Republic of China
| | - Yuexiang Xu
- Guigang Center for Disease Control and Prevention, Guigang, 537100, Guangxi, People's Republic of China
| | - Qiao Tang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Xianjun Liang
- Guigang Center for Disease Control and Prevention, Guigang, 537100, Guangxi, People's Republic of China
| | - Bing Peng
- People's Hospital of Guigang, Guigang, 537100 Guangxi, People's Republic of China
| | - Yi Shao
- Guigang Maternal and Child Health Hospital, Guigang, 537100 Guangxi, People's Republic of China
| | - Yao Yang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Jie Chen
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Xinwei Wang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Liufang Wen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Bingyu Liang
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Li Ye
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Xionglin Qin
- Guigang Center for Disease Control and Prevention, Guigang, 537100, Guangxi, People's Republic of China
| | - Junjun Jiang
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Hao Liang
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
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5
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Fan Q, Zhang J, Luo M, Yao J, Ge R, Yan Y, Ding X, Chen W, Pan X. Analysis of the Driving Factors of Active and Rapid Growth Clusters Among CRF07_BC-Infected Patients in a Developed Area in Eastern China. Open Forum Infect Dis 2021; 8:ofab051. [PMID: 33728360 PMCID: PMC7944347 DOI: 10.1093/ofid/ofab051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/29/2021] [Indexed: 11/22/2022] Open
Abstract
Background The purpose of this study was to research the molecular transmission and genetic evolutionary characteristics among CRF07_BC-infected patients in a developed area in Eastern China. Methods Plasma samples from newly diagnosed HIV-1-positive patients from 2015–2018 and basic demographic and epidemiological information were obtained. Pol sequences from CRF07_BC-infected patients were selected for phylogenetic, molecular transmission network, and Bayesian evolutionary analyses. Results Pol sequences were successfully obtained from 258 samples of CRF07_BC. Phylogenetic analysis revealed 2 distinct lineages: lineage 1 (66.3%, 171/258), primarily from men who have sex with men (MSM) and some heterosexual individuals, and lineage 2 (33.7%, 87/258), primarily from heterosexual individuals. Under an optimal genetic distance of 0.01 substitutions/site, 163 individuals (63.2%, 163/258) formed 23 groups comprising 6 clusters and 17 dyads in the networks. A distinctly large and rapidly growing cluster (C1) containing 105 individuals was identified, in which MSM with ≥4 links had quite a high transmission risk (low educational background, active sexual behavior, low sexual protection awareness, etc.). According to Bayesian analyses, most C1 clades formed from 2005 to 2009, most of which were closely geographically related to CRF07_BC epidemic strains from Anhui province. Conclusions Here, we elucidated the local transmission characteristics and epidemic pattern of HIV-1 CRF07_BC, revealing that MSM (especially with ≥4 links) may be a significant driver in the formation of active and rapid growth networks in regional CRF07_BC epidemics. Thus, unique region– and risk group–specific transmission network analysis based on a molecular approach can provide critical and insightful information for more effective intervention strategies to limit future HIV-1 transmission.
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Affiliation(s)
- Qin Fan
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jiafeng Zhang
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Mingyu Luo
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jiaming Yao
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Rui Ge
- Division of AIDS/TB Prevention and Control, Jiaxing Municipal Center for Disease Control and Prevention, Jiaxing, China
| | - Yong Yan
- Division of AIDS/TB Prevention and Control, Jiaxing Municipal Center for Disease Control and Prevention, Jiaxing, China
| | - Xiaobei Ding
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Wanjun Chen
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaohong Pan
- Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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[Self-reported infections in the German National Cohort (GNC) in the context of the current research landscape]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:404-414. [PMID: 32185449 DOI: 10.1007/s00103-020-03114-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Infectious diseases continue to play an important role for disease perception, health-economic considerations and public health in Germany. In recent years, infectious diseases have been linked to the development of non-communicable diseases. Analyses of the German National Cohort (GNC) may provide deeper insights into this issue and pave the way for new targeted approaches in disease prevention. OBJECTIVES The aim was to describe the tools used to assess infectious diseases and to present initial data on infectious disease frequencies, as well as to relate the GNC assessment tools to data collection methods in other studies in Germany. METHODS As part of the baseline examination, questions regarding infectious diseases were administered using both an interview and a self-administered touchscreen questionnaire. Data from the initial 101,787 GNC participants were analysed. RESULTS In the interview, 0.2% (HIV/AIDS) to 8.6% (shingles) of respondents reported ever having a medical diagnosis of shingles, postherpetic neuralgia (in cases where shingles was reported), hepatitis B/C, HIV/AIDS, tuberculosis or sepsis if treated in hospital. In the questionnaire, 12% (cystitis) to 81% (upper respiratory tract infections) of respondents reported having experienced at least one occurrence of upper or lower respiratory tract infections, gastrointestinal infections, cystitis or fever within the past 12 months. OUTLOOK The cross-sectional analyses of data and tools presented here - for example on determinants of susceptibility to self-reported infections - can be anticipated from the year 2021 onward. Beyond that, more extensive research into infectious disease epidemiology will follow, particularly once analyses of GNC biological materials have been performed.
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Molecular network-based intervention brings us closer to ending the HIV pandemic. Front Med 2020; 14:136-148. [PMID: 32206964 DOI: 10.1007/s11684-020-0756-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/13/2020] [Indexed: 01/08/2023]
Abstract
Precise identification of HIV transmission among populations is a key step in public health responses. However, the HIV transmission network is usually difficult to determine. HIV molecular networks can be determined by phylogenetic approach, genetic distance-based approach, and a combination of both approaches. These approaches are increasingly used to identify transmission networks among populations, reconstruct the history of HIV spread, monitor the dynamics of HIV transmission, guide targeted intervention on key subpopulations, and assess the effects of interventions. Simulation and retrospective studies have demonstrated that these molecular network-based interventions are more cost-effective than random or traditional interventions. However, we still need to address several challenges to improve the practice of molecular network-guided targeting interventions to finally end the HIV epidemic. The data remain limited or difficult to obtain, and more automatic real-time tools are required. In addition, molecular and social networks must be combined, and technical parameters and ethnic issues warrant further studies.
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8
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Martin TCS, Chaillon A, Graves SK, Lin T, Gianella S, Smith DM, Little SJ, Hoenigl M. Genetic Network Analysis to Assess the Risk of Human Immunodeficiency Virus Transmission Among Men Who Have Sex With Men Seeking Partners on the Internet. Clin Infect Dis 2020; 70:925-932. [PMID: 30953067 PMCID: PMC7319271 DOI: 10.1093/cid/ciz278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/01/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Online partner seeking (OPS) among men who have sex with men (MSM) is associated with increased risk behavior including frequency of unprotected anal intercourse, number of partners, and incidence of sexually transmitted infections (STIs). However, the impact on transmission of human immunodeficiency virus (HIV) is uncertain. METHODS MSM diagnosed with acute and early HIV infection were recruited from the Primary Infection Resource Consortium. HIV transmission events in the year following infection were inferred using estimated date of infection combined with genetic network analysis with linked sequences defined as ≤0.015 sequences/site difference in the HIV type 1 (HIV-1) pol coding region. Participants completed a detailed baseline questionnaire including reported methods of meeting sexual partners, including OPS, in the prior 3 months, and regression was performed with inferred transmission as the outcome. RESULTS From 147 MSM who completed the questionnaire, there were an associated 20 inferred HIV transmissions. No association with OPS was found (odds ratio, 0.64 [95% confidence interval, .24-1.69]; P = .37), though individuals who reported OPS were more likely to have reported a greater number of partners (P = .003) and prior STIs (P = .002). Geospatial analysis did not indicate that OPS was associated with increased geographical reach of the user (P = .68). CONCLUSIONS Individuals reporting OPS did not have increased odds of inferred HIV-1 transmission in the year following infection using genetic linkage analysis despite apparently increased risk behavior. OPS also did not increase the geographic distance between genetically clustered HIV infections, suggesting that individuals mainly use the internet to meet partners in their local region.
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Affiliation(s)
- Thomas C S Martin
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California
| | - Antoine Chaillon
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California
| | - Susannah K Graves
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California
| | - Timothy Lin
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California
| | - Sara Gianella
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California
| | - Davey M Smith
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California
- San Diego Veterans Affairs Health System, California
| | - Susan J Little
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California
| | - Martin Hoenigl
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California
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9
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Kessler HH, Stelzl E, Blažič A, Mehta SR, Benezeder AS, Genger-Hackl C, Santner BI, Chaillon A, Hoenigl M. Antiretroviral Treatment Simplification With 2-Drug Regimens: Impact of Transmitted Drug Resistance Mutations. Open Forum Infect Dis 2020; 7:ofz535. [PMID: 31915716 PMCID: PMC6942491 DOI: 10.1093/ofid/ofz535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/16/2019] [Indexed: 11/13/2022] Open
Abstract
The frequency of clinically relevant transmitted drug resistance mutations (DRMs) against drugs used for 2-drug regimens was 15.6%, but only 2% were not eligible for 1 or more 2-drug regimens. More than 50% of patients harboring any clinically relevant DRMs were found to be part of genetic transmission clusters.
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Affiliation(s)
- Harald H Kessler
- Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, Graz, Austria
| | - Evelyn Stelzl
- Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, Graz, Austria
| | - Anja Blažič
- Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, Graz, Austria
| | - Sanjay R Mehta
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
- Department of Medicine, San Diego VA Medical Center, San Diego, California, USA
| | - Anna S Benezeder
- Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, Graz, Austria
| | - Christina Genger-Hackl
- Department of Gastroenterology and Infectious Diseases, Academic Hospital Graz II, Graz, Austria
| | - Brigitte I Santner
- Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, Graz, Austria
| | - Antoine Chaillon
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Martin Hoenigl
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
- Division of Pulmonology and Section of Infectious Diseases, Medical University of Graz, Graz, Austria
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10
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Hoenigl M, Hassan A, Moore DJ, Anderson PL, Corado K, Dubé MP, Ellorin EE, Blumenthal J, Morris SR. Predictors of Long-Term HIV Pre-exposure Prophylaxis Adherence After Study Participation in Men Who Have Sex With Men. J Acquir Immune Defic Syndr 2019; 81:166-174. [PMID: 30865175 PMCID: PMC6522282 DOI: 10.1097/qai.0000000000002003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Efficacy of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men is well documented in randomized trials. After trial completion, participants are challenged with acquiring PrEP on their own and remaining adherent. METHODS This was a follow-up study of the TAPIR randomized controlled multicenter PrEP trial. Participants were contacted after their last TAPIR visit (ie, after study-provided PrEP was discontinued) to attend observational posttrial visits 24 and 48 weeks later. Adherence during TAPIR and posttrial visits was estimated by dried blood spot intracellular tenofovir diphosphate levels (adequate adherence defined as tenofovir diphosphate levels >719 fmol/punch). Binary logistic regression analysis assessed predictors of completing posttrial visits and PrEP adherence among participants completing ≥1 visit. RESULTS Of 395 TAPIR participants who were on PrEP as part of the TAPIR trial for a median of 597 days (range 3-757 days), 122 (31%) completed ≥1 posttrial visit (57% of University of California San Diego participants completed posttrial visits, whereas this was 13% or lower for other study sites). Among participants who completed ≥1 posttrial visit, 57% had adequate adherence posttrial. Significant predictors of adequate adherence posttrial were less problematic substance use, higher risk behavior, and adequate adherence in year 1 of TAPIR. CONCLUSION More than half of PrEP users followed after trial completion had successfully acquired PrEP and showed adequate adherence. Additional adherence monitoring and intervention measures may be needed for those with low PrEP adherence and problematic substance use during the first year of trial.
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Affiliation(s)
- Martin Hoenigl
- University of California San Diego (UCSD), San Diego, California, United States
| | - Adiba Hassan
- University of California San Diego (UCSD), San Diego, California, United States
| | - David J. Moore
- University of California San Diego (UCSD), San Diego, California, United States
| | - Peter L. Anderson
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Katya Corado
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Michael P. Dubé
- Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Eric E. Ellorin
- University of California San Diego (UCSD), San Diego, California, United States
| | - Jill Blumenthal
- University of California San Diego (UCSD), San Diego, California, United States
| | - Sheldon R. Morris
- University of California San Diego (UCSD), San Diego, California, United States
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Stecher M, Chaillon A, Eis-Hübinger AM, Lehmann C, Fätkenheuer G, Wasmuth JC, Knops E, Vehreschild JJ, Mehta S, Hoenigl M. Pretreatment human immunodeficiency virus type 1 (HIV-1) drug resistance in transmission clusters of the Cologne-Bonn region, Germany. Clin Microbiol Infect 2019; 25:253.e1-253.e4. [PMID: 30315957 PMCID: PMC6349503 DOI: 10.1016/j.cmi.2018.09.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/25/2018] [Accepted: 09/28/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES In Germany, previous reports have demonstrated transmitted human immunodeficiency virus type 1 (HIV-1) drug-resistance mutations (DRM) in 11% of newly diagnosed individuals, highlighting the importance of drug-resistance screening before the initiation of antiretroviral therapy (ART). Here, we sought to understand the molecular epidemiology of HIV DRM transmission in the Cologne-Bonn region of Germany, given one of the highest rates of new HIV diagnoses in western Europe (13.7 per 100 000 habitants). METHODS We analysed 714 HIV-1 ART-naive infected individuals diagnosed at the University Hospitals Cologne and Bonn between 2001 and 2016. Screening for DRM was performed according to the Stanford University Genotypic Resistance Interpretation. Shared DRM were defined as any DRM present in genetically linked individuals (<1.5% genetic distance). Phylogenetic and network analyses were performed to infer putative relationships and shared DRM. RESULTS The prevalence of any DRM at time of diagnosis was 17.2% (123/714 participants). Genetic transmission network analyses showed comparable frequencies of DRM in clustering versus non-clustering individuals (17.1% (85/497) versus 17.5% (38/217)). The observed rate of DRM in the region was higher than previous reports 10.8% (87/809) (p < 0.001), revealing the need to reduce onward transmission in this area. Genetically linked individuals harbouring shared DRM were more likely to live in suburban areas (24/38) than in central Cologne (1/38) (p < 0.001). CONCLUSION The rate of DRM was exceptionally high. Network analysis elucidated frequent cases of shared DRM among genetically linked individuals, revealing the potential spread of DRM and the need to prevent onward transmission of DRM in the Cologne-Bonn area.
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Affiliation(s)
- M Stecher
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - A Chaillon
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA.
| | - A M Eis-Hübinger
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
| | - C Lehmann
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - G Fätkenheuer
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J-C Wasmuth
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany; Department for Internal Medicine I, University Hospital of Bonn, Bonn, Germany
| | - E Knops
- Institute of Virology, University Hospital of Cologne, Cologne, Germany
| | - J J Vehreschild
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - S Mehta
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA; Department of Medicine, San Diego VA Medical Centre, San Diego, CA, USA
| | - M Hoenigl
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA; Division of Pulmonology and Section of Infectious Diseases, Medical University of Graz, Graz, Austria
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