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.

项目概要 2019 年底 COVID-19 大流行开始时，估计有 120 万人，其中 158,500 人 (13%) 未确诊感染——在美国感染艾滋病毒。 由于艾滋病毒检测、护理相关服务和病例监测工作受到干扰，情况变得更加复杂 然而，COVID-19 大流行对 HIV 的全面影响。 传播、发生率和结果很难量化。 基于废水的流行病学 (WBE) 是一种非侵入性、公正的监测方法，可以 用于通过检测体内病原体 DNA 或 RNA 来估计人群中传染病的发生情况 在这里，我们建议应用一种新型的 WBE HIV 监测。 测量废水中 HIV-1 核酸的方法，以估计污水处理厂中 HIV 发病率 COVID-19 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 (2) 在 30 名 HIV 感染者中，将尿液中的 HIV 核酸（RNA 和 DNA）脱落与 含有血浆病毒载量的粪便，以及 (3) 使用圣克拉拉和圣保罗的废水存档样本 COVID 大流行期间的弗朗西斯科县，以确定废水中 HIV-1 酸的趋势 水平并将研究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基于废水的 HIV 定量方法 使用数字液滴、逆转录 PCR 分析进行监测，可用于监测艾滋病毒 我们认为废水监测可以不成比例地识别人群。 受艾滋病毒影响，促进将资源分配给高危人群，从而最大限度地减少艾滋病毒感染 调查废水中与 COVID-19 相关的 HIV 核酸变化率也可能。 提高我们对流行病及其控制策略如何影响艾滋病毒监测的了解 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进行监测，可以减少健康差异，改善健康结果 并预防艾滋病毒传播。