Timely monitoring and response to HIV transmission networks for intensified prevention

及时监测和应对艾滋病毒传播网络，加强预防

• 批准号: 10357867
• 负责人: Ann Dennis
• 金额: $ 62.66万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-03-05 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10357867
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Acute; Address; Annual Reports; Area; Caring; Case Study; Characteristics; Chronic; Clinical; Cluster Analysis; Collaborations; Contact Tracing; County; Coupled; Data; Deposition; Detection; Diagnosis; Diagnostic; Disease; Early Diagnosis; Ensure; Epidemic; Epidemiology; Ethnic Origin; Generations; Genetic; Geographic Distribution; Geographic Locations; Geography; Growth; HIV; HIV Infections; HIV diagnosis; HIV/STD; Human immunodeficiency virus test; Incidence; Infection; Interruption; Intervention; Knowledge; Laboratories; Link; Measures; Modeling; Molecular; Monitor; Newly Diagnosed; North Carolina; Outcome; Persons; Phylogenetic Analysis; Population; Prevention; Prevention Measures; Professional counselor; Public Health; Race; Reporting; Resolution; Risk Behaviors; Risk Factors; Rural; STI prevention; Sequence Analysis; Services; Site; Social Network; Specialist; Specimen; Subgroup; System; Systems Analysis; Testing; Time; United States; United States Dept. of Health and Human Services; Viral Load result; Work; antiretroviral therapy; base; black men; cost effective; deep sequencing; demographics; design; effective intervention; epidemiologic data; experience; high risk population; improved; indexing; insight; mathematical model; member; men who have sex with men; next generation sequencing; peer; population based; pre-exposure prophylaxis; prospective; response; service intervention; social; success; surveillance data; tool; transmission process; urban area; young man; young men who have sex with men

PROJECT SUMMARY Tracking population-based HIV transmission dynamics is critical to design and monitor effective interventions. Despite widespread prevention, HIV incidence has failed to decline among some subgroups in the United States (US) including young men who have sex with men (MSM). Such disparities are notable in the Southern US which is at the epicenter of the national epidemic with the greatest burden in new and prevalent infections. Significant disparities in HIV infection exist based on race/ethnicity and risk behaviors, but also in geography; a higher proportion of cases are reported outside large urban areas compared to other regions. Delineating HIV transmission dynamics in the Southern US can identify ongoing transmission networks or clusters where targeted prevention measures may be more impactful at reducing local incidence. However, the success of such measures requires timely identification and response to emerging or expanding clusters. Prospective phylogenetic analyses of HIV sequences integrated with epidemiologic and clinical surveillance data would facilitate the timely detection and monitoring of transmission networks. When combined with phylodynamic modeling, cluster expansion and transmission dynamics could be better predicted and the impact of interventions assessed. Our overall hypotheses are: 1) Prospective phylogenetic cluster analysis allows timely identification of transmission chains not apparent through routine surveillance, 2) Persons identified in expanding clusters represent the leading edge of local transmission, i.e. recent infection, 3) Targeting prevention towards growing clusters will identify a higher proportion of recent infections and ultimately reduce incidence. These hypotheses will be addressed in North Carolina (NC) with three specific aims: Aim 1: To describe the demographic and geographical characteristics of HIV transmission involving persons with newly reported HIV infection using phylogenetic clustering, viral load, and risk behaviors; Aim 2: To assess HIV cluster expansion and inform phylodynamic models by integrating large-scale deep sequencing and contact networks involving cases with newly diagnosed HIV infection; Aim 3: To conduct a preliminary assessment of a cluster-directed partner services intervention to interrupt HIV transmission networks. These aims will be addressed through a combination of strategies in collaboration with the NC Department of Health and Human Services. A statewide prospective, automated cluster analysis system (nextHIV) will be evaluated. Sequences from reference laboratories and deep sequencing of diagnostic specimens from public testing sites will be analyzed in near-real time. Clusters will be characterized with detailed epidemiological data including HIV viral loads and contact networks. A proof-of-concept, cluster-directed partner services intervention will be assessed in an 11 county region with high HIV burden. Phylodynamic and mathematical modeling will be used to assess cluster expansion and the potential impact of interventions.

项目总结 跟踪以人群为基础的艾滋病毒传播动态对于设计和有效监测至关重要 干预措施。尽管进行了广泛的预防，但在#年，艾滋病毒在一些亚组中的发病率未能下降 美国包括与男性发生性关系的年轻男性(MSM)。这种差异在以下方面值得注意 美国南部是全国疫情的震中，在新的和流行的疾病中负担最大 感染。艾滋病毒感染在种族/民族和危险行为方面存在显著差异，但在 地理位置；与其他地区相比，大城市以外地区报告的病例比例较高。 描绘美国南部的艾滋病毒传播动态可以识别正在进行的传播网络或 有针对性的预防措施在减少当地发病率方面可能更有效的群组。然而， 这类措施的成功需要及时查明和应对正在出现或扩大的集群。 结合流行病学和临床监测的HIV序列前瞻性系统发育分析 数据将有助于及时检测和监测传输网络。当与 系统动力学建模、集群扩展和传播动力学可以更好地预测，并且 评估干预措施的影响。 我们的总体假设是：1)前瞻性的系统发育聚类分析能够及时识别 通过常规监测不明显的传播链，2)在扩大集群中发现的人 代表当地传播的前沿，即最近的感染，3)针对增长的预防 聚集性将识别更高比例的近期感染，并最终降低发病率。这些假设 将在北卡罗来纳州(北卡罗来纳州)讨论，有三个具体目标：目标1：描述人口和 涉及新报告的艾滋病毒感染者的艾滋病毒传播的地理特征 系统发育聚集性、病毒载量和危险行为；目标2：评估艾滋病毒聚集性扩展和告知 整合大规模深度测序和接触网络的系统动力学模型 新诊断的艾滋病毒感染；目标3：对群集性伙伴进行初步评估 中断艾滋病毒传播网络的服务干预。 这些目标将通过与NC部门合作的战略组合来实现 卫生与公众服务部。全州范围内具有前瞻性的自动化集群分析系统(NextHIV)将 已评估。参考实验室的序列和公共诊断样本的深度测序 测试地点将被近乎实时地分析。集群将以详细的流行病学数据为特征 包括艾滋病毒病毒载量和接触网络。概念验证、面向群集的合作伙伴服务 干预措施将在艾滋病毒负担较高的11个县地区进行评估。系统动力学和数学 建模将用于评估集群扩展和干预措施的潜在影响。

项目成果

HIV-1 Transmission linkages among persons with incident infection to inform public health surveillance.

• DOI: 10.1016/j.eclinm.2021.100968
• 发表时间: 2021-07
• 期刊: EClinicalMedicine
• 影响因子: 15.1
• 作者: Dennis AM;Frost SDW;Enders K;Cressman AE;Volz E;Adams N;Miller WC;Cohen MS;Mobley V;Samoff E;Eron JJ
• 通讯作者: Eron JJ

Network Interconnectivity and Community Detection in HIV/Syphilis Contact Networks Among Men Who Have Sex With Men.

• DOI: 10.1097/olq.0000000000001250
• 发表时间: 2020-11
• 期刊: Sexually transmitted diseases
• 影响因子: 3.1
• 作者: Billock RM;Mucha PJ;Samoff E;Dennis AM;Pence BW;Lund JL;Powers KA
• 通讯作者: Powers KA

Intersection of Syphilis and Human Immunodeficiency Virus (HIV) Networks to Identify Opportunities to Enhance HIV Prevention.

梅毒和人类免疫缺陷病毒 (HIV) 网络的交叉点，以确定加强艾滋病毒预防的机会。

• DOI: 10.1093/cid/ciab431
• 发表时间: 2022
• 期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
• 作者: Dennis,AnnM;Cressman,Andrew;Pasquale,Dana;Frost,SimonDW;Kelly,Elizabeth;Guy,Jalila;Mobley,Victoria;Samoff,Erika;Hurt,ChristopherB;Mcneil,Candice;Hightow-Weidman,Lisa;Carry,Monique;Hogben,Matthew;Seña,ArleneC
• 通讯作者: Seña,ArleneC

HIV-1 molecular diversity in Brazil unveiled by 10 years of sampling by the national genotyping network.

• DOI: 10.1038/s41598-021-94542-5
• 发表时间: 2021-08-04
• 期刊: Scientific reports
• 影响因子: 4.6
• 作者: Gräf T;Bello G;Andrade P;Arantes I;Pereira JM;da Silva ABP;Veiga RV;Mariani D;Boullosa LT;Arruda MB;Fernandez JCC;Dennis AM;Rasmussen DA;Tanuri A
• 通讯作者: Tanuri A

Identification of Hidden Population Structure in Time-Scaled Phylogenies.

• DOI: 10.1093/sysbio/syaa009
• 发表时间: 2020-09-01
• 期刊: Systematic biology
• 影响因子: 6.5
• 作者: Volz EM;Carsten W;Grad YH;Frost SDW;Dennis AM;Didelot X
• 通讯作者: Didelot X