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.

项目摘要 跟踪基于人群的艾滋病毒传播动态对于设计和监视有效至关重要 干预措施。尽管预防广泛，但艾滋病毒的发病率未能下降 美国（美国），包括与男人发生性关系的年轻人（MSM）。这样的差异在 美国南部是国家流行病的中心，新的和普遍的负担最大 感染。基于种族/种族和风险行为存在艾滋病毒感染的显着差异，但也在 地理;与其他地区相比，在大型城市地区以外的案件中有更高比例的病例。 划定美国南部的艾滋病毒传播动态可以确定正在进行的传输网络或 有针对性预防措施的集群可能会在降低局部发病率方面具有更大的影响力。但是， 此类措施的成功需要及时识别和对新兴或扩展集群的响应。 与流行病学和临床监测整合的HIV序列的前瞻性系统发育分析 数据将有助于及时检测和监视传输网络。合并时 可以更好地预测系统动力学建模，聚类扩展和传播动力学 评估干预措施的影响。 我们的总体假设是：1）前瞻性系统发育集群分析允许及时识别 传输链通过常规监视不明显，2）在扩展集群中确定的人 代表局部传播的前沿，即最近感染，3）针对预防 集群将确定近期感染的比例，并最终降低发病率。这些假设 将在北卡罗来纳州（NC）以三个具体目的来解决：目标1：描述人口统计和 艾滋病毒传播的地理特征涉及新报告的艾滋病毒感染的人 系统发育聚类，病毒负荷和风险行为；目标2：评估HIV群集扩展并告知 系统动力学模型通过整合大规模深度测序和涉及案例的接触网络 新诊断的HIV感染；目标3：进行集群定向合作伙伴的初步评估 服务干预中断HIV传输网络。 这些目标将通过与NC部门合作的策略结合来解决 卫生和人类服务。全州的前瞻性，自动集群分析系统（NEXTHIV）将是 评估。参考实验室的序列和公众对诊断标本的深入测序 测试地点将在近乎实际的时间内进行分析。集群将以详细的流行病学数据来表征 包括HIV病毒载荷和接触网络。概念验证，集群指导的合作伙伴服务 干预措施将在艾滋病毒高负担的11个县地区进行评估。系统动力学和数学 建模将用于评估群集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

HIV Molecular Epidemiology: Tool of Oppression or Empowerment?

• DOI: 10.1080/15265161.2020.1806392
• 发表时间: 2020-10
• 期刊: The American journal of bioethics : AJOB
• 作者: Rennie S;Sullivan K;Dennis A
• 通讯作者: Dennis A