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Molecular epidemiology of HIV and Neisseria gonorrhoeae in the context of drug resistance

耐药背景下艾滋病毒和淋病奈瑟菌的分子流行病学

基本信息

批准号：
10328226
负责人：
Claire C Bristow
金额：
$ 13.71万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-01-01 至 2022-07-19
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10328226
关键词：
AIDS/HIV problem Address Antibiotic Resistance Antimicrobial Resistance Antimicrobial susceptibility Antiretroviral resistance Area Azithromycin Behavioral Biological California Centers for Disease Control and Prevention (U.S.)Cephalosporins Characteristics Clinical Complement Contact Tracing Data Development Diagnosis Disease Drug resistance Drug-resistant Neisseria Gonorrhoeae Epidemiology Ethics Event Funding Genetic Genetic Research Genome Geography Goals Gonorrhea HIV HIV Seronegativity HIV antiretroviral HIV drug resistance HIV resistance Individual Infection Infrastructure Intervention Knowledge Lead Mentors Mexico Molecular Epidemiology Molecular Genetics National Institute of Drug Abuse Neisseria gonorrhoeae Phenotype Phylogenetic Analysis Population Surveillance Predisposition Prevention Public Health Records Reporting Research Research Activity Research Personnel Research Priority Resistance Risk Risk Behaviors Sampling Sequence Analysis Sexual Partners Sexually Transmitted Diseases Single Nucleotide Polymorphism Structure Surveillance Program Symptoms Techniques Technology Testing Time Training Treatment outcome United States National Institutes of Health Variant Work career co-infection drug development evidence base experience global health improved innovation medication compliance men men who have sex with men next generation pathogen public health intervention resistant strain screening skills social sociodemographics substance use surveillance data surveillance strategy tool transmission process treatment response

项目摘要

Abstract Neisseria gonorrhoeae (NG) infection is a potential driver of HIV acquisition and transmission. The dynamic structure of transmission networks governs the spread of infection and can inform public health control efforts. HIV and NG transmission networks may overlap and the overlap can help identify at-risk HIV uninfected individuals. The structure of the NG transmission network can be used as a tool for HIV network inference and potential changes in the network over time. Over the past 75 years, NG infections have become increasingly resistant to antimicrobial therapy. Cephalosporins in combination with azithromycin are a last line treatment option for NG infection and cases of reduced susceptibility to these agents have already been documented. The U.S. Centers for Disease Control and Prevention (CDC) has identified drug-resistant NG as one of the top three urgent infectious threats. Antiretroviral resistant HIV is also an important public health problem that is associated with poorer treatment outcomes and reduced virologic suppression that could lead to increased risk of transmission. The impact of antibiotic resistant NG on HIV transmission is unknown, however, drug resistant HIV and NG may uniquely impact the transmission networks. This project will support my development as an independent researcher with expertise in molecular epidemiology by providing me with intensive training in scientific areas that are critical for understanding the global health threat of HIV and NG, including molecular epidemiology and genetic sequence analysis. The proposed project will use genetic sequence data from HIV and NG to understand the spread and potential transmission dynamics of these infections in Tijuana, Mexico and San Diego, California, an important border region. The data generated through the proposed work will strengthen local HIV and NG prevention and control efforts, enhance surveillance data for antibiotic resistant NG, and inform targeted prevention and intervention efforts in this busy border region. Through determination of the structure of HIV and NG transmission networks and an understanding of the factors that drive the transmission of these pathogens, screening, contact tracing and prevention can be appropriately targeted to maximally disrupt HIV and NG transmission networks. This project will build on my background in global health epidemiology and facilitate expertise in HIV and NG molecular epidemiology and antibiotic resistance. The specific training foci will be: 1) genetic sequence analysis of HIV and NG, 2) inference of transmission networks; 3) ethical conduct of prevention, diagnosis and phylogenetic analysis research of HIV and NG; and 4) skills for a successful academic career. I will receive my training from experienced mentors with outstanding track records in molecular genetics research. Each mentor has complementary areas of expertise relevant to my training needs. This proposal builds on previous NIH funded research and complements current NIH funded projects lead by my mentoring team.

摘要淋病奈瑟菌(NG)感染是HIV感染和传播的潜在驱动因素。动态感传播网络的结构支配着感染的传播，并可为公共卫生控制工作提供信息。 HIV和NG的传播网络可能会重叠，这种重叠可以帮助识别未感染的高危HIV 个人。NG传输网络的结构可以作为HIV网络推理和随着时间的推移，网络中的潜在变化。在过去的75年里，NG感染变得越来越多对抗菌药物治疗有抵抗力。头孢菌素联合阿奇霉素是最后的治疗方法对于NG感染的选择和对这些药物敏感性降低的案例已经被记录在案。美国疾病控制和预防中心(CDC)已将耐药NG确定为最常见的三个紧急的传染病威胁。抗逆转录病毒耐药性艾滋病毒也是一个重要的公共卫生问题，即与较差的治疗结果和减少的病毒抑制有关，这可能会导致风险增加变速箱。耐药NG对HIV传播的影响尚不清楚，然而，耐药艾滋病毒和新城疫可能会对传播网络产生独特的影响。这个项目将支持我作为一名具有分子专业知识的独立研究员的发展。流行病学，为我提供科学领域的强化培训，这些领域对于理解艾滋病毒和新城疫对全球健康的威胁，包括分子流行病学和基因序列分析。这个拟议的项目将使用艾滋病毒和新城疫的基因序列数据来了解传播和潜在的这些感染在墨西哥提华纳和加利福尼亚州圣地亚哥的传播动态是重要的区域。通过拟议工作产生的数据将加强当地艾滋病毒和新城疫的预防和控制努力，加强耐抗生素新城疫的监测数据，并提供有针对性的预防和干预措施在这个繁忙的边境地区的努力。通过确定HIV和NG传播网络的结构以及了解驱动这些病原体传播的因素、筛查、接触者追踪可以适当地针对预防，最大限度地扰乱艾滋病毒和NG传播网络。这个项目将建立在我在全球卫生流行病学方面的背景之上，并促进在艾滋病毒和新城疫方面的专业知识分子流行病学和抗生素耐药性。具体的训练重点将是：1)遗传序列艾滋病毒和新城疫的分析，2)传播网络的推断；3)预防、诊断和道德行为 HIV和NG的系统发育分析研究；以及4)成功学术生涯的技能。我会收到我的培训由在分子遗传学研究方面有出色记录的经验丰富的导师提供。每位导师具有与我的培训需求相关的互补专业知识领域。这项提议建立在以前NIH的基础上资助的研究和补充目前由我的指导团队领导的NIH资助的项目。