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Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission

Tailoring public health responses to growing HIV transmission clusters depends on accurately mapping the risk network through which it spreads and identifying acute infections that represent the leading edge of cluster growth. HIV transmission links, especially those involving persons with acute HIV...

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Autores principales: Campbell, Ellsworth M., Patala, Anne, Shankar, Anupama, Li, Jin-Fen, Johnson, Jeffrey A., Westheimer, Emily, Gay, Cynthia L., Cohen, Stephanie E., Switzer, William M., Peters, Philip J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077189/
https://www.ncbi.nlm.nih.gov/pubmed/32012700
http://dx.doi.org/10.3390/v12020145
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author Campbell, Ellsworth M.
Patala, Anne
Shankar, Anupama
Li, Jin-Fen
Johnson, Jeffrey A.
Westheimer, Emily
Gay, Cynthia L.
Cohen, Stephanie E.
Switzer, William M.
Peters, Philip J.
author_facet Campbell, Ellsworth M.
Patala, Anne
Shankar, Anupama
Li, Jin-Fen
Johnson, Jeffrey A.
Westheimer, Emily
Gay, Cynthia L.
Cohen, Stephanie E.
Switzer, William M.
Peters, Philip J.
author_sort Campbell, Ellsworth M.
collection PubMed
description Tailoring public health responses to growing HIV transmission clusters depends on accurately mapping the risk network through which it spreads and identifying acute infections that represent the leading edge of cluster growth. HIV transmission links, especially those involving persons with acute HIV infection (AHI), can be difficult to uncover, or confirm during partner services investigations. We integrated molecular, epidemiologic, serologic and behavioral data to infer and evaluate transmission linkages between participants of a prospective study of AHI conducted in North Carolina, New York City and San Francisco from 2011–2013. Among the 547 participants with newly diagnosed HIV with polymerase sequences, 465 sex partners were reported, of whom only 35 (7.5%) had HIV sequences. Among these 35 contacts, 23 (65.7%) links were genetically supported and 12 (34.3%) were not. Only five links were reported between participants with AHI but none were genetically supported. In contrast, phylodynamic inference identified 102 unreported transmission links, including 12 between persons with AHI. Importantly, all putative transmission links between persons with AHI were found among large clusters with more than five members. Taken together, the presence of putative links between acute participants who did not name each other as contacts that are found only among large clusters underscores the potential for unobserved or undiagnosed intermediaries. Phylodynamics identified many more links than partner services alone and, if routinely and rapidly integrated, can illuminate transmission patterns not readily captured by partner services investigations.
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spelling pubmed-70771892020-03-20 Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission Campbell, Ellsworth M. Patala, Anne Shankar, Anupama Li, Jin-Fen Johnson, Jeffrey A. Westheimer, Emily Gay, Cynthia L. Cohen, Stephanie E. Switzer, William M. Peters, Philip J. Viruses Article Tailoring public health responses to growing HIV transmission clusters depends on accurately mapping the risk network through which it spreads and identifying acute infections that represent the leading edge of cluster growth. HIV transmission links, especially those involving persons with acute HIV infection (AHI), can be difficult to uncover, or confirm during partner services investigations. We integrated molecular, epidemiologic, serologic and behavioral data to infer and evaluate transmission linkages between participants of a prospective study of AHI conducted in North Carolina, New York City and San Francisco from 2011–2013. Among the 547 participants with newly diagnosed HIV with polymerase sequences, 465 sex partners were reported, of whom only 35 (7.5%) had HIV sequences. Among these 35 contacts, 23 (65.7%) links were genetically supported and 12 (34.3%) were not. Only five links were reported between participants with AHI but none were genetically supported. In contrast, phylodynamic inference identified 102 unreported transmission links, including 12 between persons with AHI. Importantly, all putative transmission links between persons with AHI were found among large clusters with more than five members. Taken together, the presence of putative links between acute participants who did not name each other as contacts that are found only among large clusters underscores the potential for unobserved or undiagnosed intermediaries. Phylodynamics identified many more links than partner services alone and, if routinely and rapidly integrated, can illuminate transmission patterns not readily captured by partner services investigations. MDPI 2020-01-27 /pmc/articles/PMC7077189/ /pubmed/32012700 http://dx.doi.org/10.3390/v12020145 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Campbell, Ellsworth M.
Patala, Anne
Shankar, Anupama
Li, Jin-Fen
Johnson, Jeffrey A.
Westheimer, Emily
Gay, Cynthia L.
Cohen, Stephanie E.
Switzer, William M.
Peters, Philip J.
Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission
title Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission
title_full Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission
title_fullStr Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission
title_full_unstemmed Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission
title_short Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission
title_sort phylodynamic analysis complements partner services by identifying acute and unreported hiv transmission
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077189/
https://www.ncbi.nlm.nih.gov/pubmed/32012700
http://dx.doi.org/10.3390/v12020145
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