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开始时，估计有120万人，包括158,500人 （13％）患有未诊断的感染 - 我们在美国与艾滋病毒同住。从那以后，艾滋病毒控制 艾滋病毒测试，与护理相关的服务和病例监视的干扰使努力变得复杂 州和地方管辖区的活动。但是，COVID-19大流行对HIV的全部影响 传输，事件和结果很难量化。 基于废水的流行病学（WBE）是一种无创和无偏见的监视方法 用于通过检测病原体DNA或RNA中的病原体DNA或RNA来估计种群中传染病的发生 汇总废水的样本。在这里，我们建议应用新颖的WBE HIV监视 测量废水中的HIV-1核酸以估计下水道中的HIV入射的方法 2019冠状病毒病大流行。这项研究将追求三个具体目标：（1）开发和验证 尿液，粪便和废水中HIV-1核酸（RNA和DNA）的定量方法 固体，（2）30人患有艾滋病毒的人，尿液中的艾滋病毒核酸（RNA和DNA）脱落 具有等离子体病毒负载的粪便，（3）使用Wastewater Rom Santa Clara和San的存档样品 弗朗西斯科县在互联的大流行期间，以确定废水HIV-1核酸的趋势 水平并将发现与艾滋病毒的社区病例率进行比较。 该项目的总体目标是建立基于废水的HIV量化方法 使用数字液滴的监视，逆转录PCR分析，可用于监测HIV 社区。我们假设废水监视可以识别出不成比例的人群 受艾滋病毒的影响，支持向有最高风险的人分配资源，从而最大化艾滋病毒 控制。调查与COVID-19的废水中HIV核酸变化的发生率 提高我们对大流行病及其控制策略如何影响艾滋病毒监测的理解 和患者护理。从该项目中获得的知识将有助于建立基于废水的框架 在美国和全球范围内对艾滋病毒的监视，可以减少健康分配，改善健康状况 并防止艾滋病毒传播。