دورية أكاديمية
Near real-time monitoring of HIV transmission hotspots from routine HIV genotyping: an implementation case study.
العنوان: | Near real-time monitoring of HIV transmission hotspots from routine HIV genotyping: an implementation case study. |
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المؤلفون: | Poon AF; BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: apoon@cfenet.ubc.ca., Gustafson R; Vancouver Coastal Health Authority, Vancouver, BC, Canada., Daly P; Vancouver Coastal Health Authority, Vancouver, BC, Canada., Zerr L; Vancouver Coastal Health Authority, Vancouver, BC, Canada., Demlow SE; Vancouver Coastal Health Authority, Vancouver, BC, Canada., Wong J; BC Centre for Disease Control, Vancouver, BC, Canada., Woods CK; BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Hogg RS; BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada., Krajden M; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; BC Centre for Disease Control, Vancouver, BC, Canada., Moore D; BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; BC Centre for Disease Control, Vancouver, BC, Canada., Kendall P; Office of the Provincial Health Officer, Ministry of Health, Government of British Columbia, Victoria, BC, Canada., Montaner JS; BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada., Harrigan PR; BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada. |
المصدر: | The lancet. HIV [Lancet HIV] 2016 May; Vol. 3 (5), pp. e231-8. Date of Electronic Publication: 2016 Apr 07. |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 101645355 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2352-3018 (Electronic) Linking ISSN: 23523018 NLM ISO Abbreviation: Lancet HIV Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: [Amsterdam] : Elsevier B.V., [2014]- |
مواضيع طبية MeSH: | Epidemiological Monitoring*, HIV/*genetics , HIV Infections/*transmission , HIV Infections/*virology , Viral Load/*methods, Automation ; British Columbia/epidemiology ; Cluster Analysis ; Cost-Benefit Analysis ; Genes, Viral ; Genotype ; HIV Infections/economics ; HIV Infections/epidemiology ; Humans ; Male ; Phylogeny |
مستخلص: | Background: HIV evolves rapidly and therefore infections with similar genetic sequences are likely linked by recent transmission events. Clusters of related infections can represent subpopulations with high rates of transmission. We describe the implementation of an automated near real-time system to monitor and characterise HIV transmission hotspots in British Columbia, Canada. Methods: In this implementation case study, we applied a monitoring system to the British Columbia drug treatment database, which holds more than 32 000 anonymised HIV genotypes for nearly 9000 residents of British Columbia living with HIV. On average, five to six new HIV genotypes are deposited in the database every day, which triggers an automated reanalysis of the entire database. We extracted clusters of five or more individuals with short phylogenetic distances between their respective HIV sequences. The system generated monthly reports of the growth and characteristics of clusters that were distributed to public health officers. Findings: In June, 2014, the monitoring system detected the expansion of a cluster by 11 new cases during 3 months, including eight cases with transmitted drug resistance. This cluster generally comprised young men who have sex with men. The subsequent report precipitated an enhanced public health follow-up to ensure linkage to care and treatment initiation in the affected subpopulation. Of the nine cases associated with this follow-up, all had already been linked to care and five cases had started treatment. Subsequent to the follow-up, three additional cases started treatment and most cases achieved suppressed viral loads. During the next 12 months, we detected 12 new cases in this cluster with reduction in the onward transmission of drug resistance. Interpretation: Our findings show the first application of an automated phylogenetic system monitoring a clinical database to detect a recent HIV outbreak and support the ensuing public health response. By making secondary use of routinely collected HIV genotypes, this approach is cost-effective, attains near real-time monitoring of new cases, and can be implemented in all settings in which HIV genotyping is the standard of care. Funding: BC Centre for Excellence in HIV/AIDS, the Canadian Institutes for Health Research, the Genome Canada-CIHR Partnership in Genomics and Personalized Health, and the US National Institute on Drug Abuse. (Copyright © 2016 Elsevier Ltd. All rights reserved.) |
التعليقات: | Comment in: Lancet HIV. 2016 May;3(5):e196-7. (PMID: 27126483) Comment in: Lancet HIV. 2016 Oct;3(10 ):e461. (PMID: 27687039) |
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معلومات مُعتمدة: | R01 DA031055 United States DA NIDA NIH HHS; R01 DA036307 United States DA NIDA NIH HHS; U01 DA021525 United States DA NIDA NIH HHS; R01 DA011591 United States DA NIDA NIH HHS; R01 DA021525 United States DA NIDA NIH HHS; Canada CIHR |
تواريخ الأحداث: | Date Created: 20160430 Date Completed: 20170612 Latest Revision: 20240325 |
رمز التحديث: | 20240325 |
مُعرف محوري في PubMed: | PMC4853759 |
DOI: | 10.1016/S2352-3018(16)00046-1 |
PMID: | 27126490 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2352-3018 |
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DOI: | 10.1016/S2352-3018(16)00046-1 |