Feasibility of conducting HIV surveillance in community wastewater

在社区废水中进行艾滋病毒监测的可行性

• 批准号: 10762254
• 负责人: Julie Parsonnet
• 金额: $ 23.17万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-23 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762254
• 关键词: 2019-nCoV; AIDS prevention; Affect; Authorization documentation; Biological Assay; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; California; Caring; Clinical; Communicable Diseases; Communities; Complement; County; DNA; Disease; Disease Surveillance; Ensure; Feces; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; HIV-1; HIV/AIDS; Health; Hospitalization; Human; Human immunodeficiency virus test; Incidence; Individual; Infection; Knowledge; Measurement; Measures; Medical; Methods; Modeling; Monitor; Monkeypox; National Institute of Allergy and Infectious Disease; Nucleic Acids; Outcome; Pathogen detection; Patient Care; Persons; Plasma; Poliomyelitis; Population; Prevalence; Public Health; RNA; Reduce health disparities; Reporting; Resource Allocation; Reverse Transcriptase Polymerase Chain Reaction; Reverse Transcription; Risk Assessment; Sampling; San Francisco; Services; Sewage; Solid; Specimen; Surveillance Methods; System; Testing; Time; Uncertainty; United States; Urine; Viral; Viral Load result; Viremia; Virus; Visit; Work; authority; community transmission; cost effective; digital; feasibility testing; high risk; improved; in vitro Assay; infection risk; interest; novel; pandemic disease; pathogen; prevent; prevention service; rate of change; recruit; research study; response; sample archive; screening; screening services; stool sample; success; time use; tool; transmission process; treatment services; trend; wastewater epidemiology; wastewater samples; wastewater surveillance; wasting

PROJECT SUMMARY At the start of the COVID-19 pandemic in late 2019, an estimated 1.2 million people—including 158,500 (13%) with undiagnosed infection—were living with HIV in the United States. Since then, HIV control efforts have been complicated by disruptions to HIV testing, care-related services, and case surveillance activities in state and local jurisdictions. However, the full impact of the COVID-19 pandemic on HIV transmission, incidence and outcomes has been difficult to quantify. Wastewater-based epidemiology (WBE) is a non-invasive and unbiased surveillance approach that can be used to estimate infectious disease occurrence in the population by detecting pathogen DNA or RNA in pooled community samples of wastewater. Here we propose to apply a novel WBE HIV surveillance method to measure HIV-1 nucleic acids in wastewater to estimate HIV incidence in sewersheds during the COVID-19 pandemic. This research study will pursue three specific aims: (1) to develop and validate a quantification method for HIV-1 nucleic acids (RNA and DNA) in urine, feces and wastewater settled solids, (2) in 30 people living with HIV, to c orrelate HIV nucleic acid (RNA and DNA) shedding in urine and feces with plasma viral load, and (3) using archived samples of wastewater rom Santa Clara and San Francisco Counties during the COVID pandemic, to determine trends in wastewater HIV-1 nucleic acid levels and compare findings with community case rates of HIV. The overarching goal of this project is to establish an HIV quantification method for wastewater-based surveillance using digital droplet, reverse transcription-PCR analysis that can be used to monitor HIV in the community. We hypothesize that wastewater surveillance can identify populations disproportionately affected by HIV, facilitating allocation of resources to those at highest risk, thereby maximizing HIV control. Investigating rates of changes in HIV nucleic acid in wastewater in relation to COVID-19 may also improve our understanding of how pandemic disease and its control strategies can impact HIV surveillance and patient care. Knowledge gained from this project will help establish a framework for wastewater-based surveillance for HIV in the US and globally that can reduce health disparities, improve health outcomes and prevent HIV transmission.

项目摘要 在2019年底COVID-19大流行开始时，估计有120万人-包括158，500人 (13%）未确诊的感染者-在美国艾滋病毒感染者。从那时起，艾滋病毒控制 艾滋病毒检测、护理相关服务和病例监测的中断使这些努力变得复杂 在州和地方司法管辖区的活动。然而，COVID-19大流行对艾滋病毒的全面影响 传播、发病率和结果难以量化。 基于水的流行病学（WBE）是一种非侵入性和无偏见的监测方法， 用于通过检测人群中的病原体DNA或RNA来估计人群中传染病的发生。 收集社区废水样本。在这里，我们提出了一种新的WBE艾滋病毒监测 一种测量废水中HIV-1核酸的方法，以估计 2019冠状病毒病大流行。本研究将追求三个具体目标：（1）开发和验证一个 尿液、粪便和废水中HIV-1核酸（RNA和DNA）的定量方法 固体，（2）在30名艾滋病毒感染者中，与尿液中的艾滋病毒核酸（RNA和DNA）脱落相关， 粪便与血浆病毒载量，以及（3）使用来自圣克拉拉和旧金山的废水存档样品 弗朗西斯科县在COVID大流行期间，以确定废水中HIV-1核酸的趋势 水平，并将调查结果与社区艾滋病毒病例率进行比较。 该项目的总体目标是建立一种艾滋病毒量化方法， 使用数字液滴进行监测，逆转录PCR分析可用于监测艾滋病毒， 社会各界我们假设，废水监测可以识别人口不成比例 艾滋病毒感染者，促进向高危人群分配资源，从而最大限度地 控制调查废水中HIV核酸与COVID-19相关的变化率也可能 提高我们对大流行病及其控制战略如何影响艾滋病毒监测的认识 和病人护理。从该项目中获得的知识将有助于建立一个以废水为基础的 在美国和全球范围内监测艾滋病毒，可以减少健康差距，改善健康结果， 预防艾滋病传播。