Contribution of HIV transmission bursts to future HIV infections.

IF 3.4 2区 医学 Q3 IMMUNOLOGY
AIDS Pub Date : 2025-08-01 Epub Date: 2024-12-23 DOI:10.1097/QAD.0000000000004101
Rachael M Billock, Anne Marie France, Neeraja Saduvala, Nivedha Panneer, Camden J Hallmark, Joel O Wertheim, Alexandra M Oster
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引用次数: 0

Abstract

Objective: To estimate the influence of bursts of rapid HIV transmission on future transmission and describe populations affected by transmission bursts.

Design: Phylogenetic analysis of US National HIV Surveillance System data.

Methods: Time-scaled phylogenetic trees were inferred for six geographic regions using sequences from persons with HIV (PWH) with diagnoses of HIV infection 2014-2019. Transmission bursts were defined as at least three adjacent inferred transmission events in the phylogeny during a detection period. We calculated the relative contribution of transmission bursts 2015-2016 to transmission 2017-2019 compared with nonbursts. Then, we detected bursts within any sliding 2-year period 2014-2019 and assessed descriptive associations of characteristics of individuals involved with or descended from transmission bursts using univariate risk ratios.

Results: The 5.6% of phylogenetic lineages involved in transmission bursts 2015-2016 contributed to 14.9% of inferred transmission events 2017-2019. The relative contribution of lineages involved in transmission bursts to future transmission was 2.94 times that of lineages not involved in bursts. Younger age at diagnosis, self-identification as transgender or an additional gender identity, or as a cisgender man, MMSC, IDU, or MMSC and IDU, and diagnosis during acute or early infection were most strongly associated with involvement in or descendance from transmission bursts.

Conclusion: Transmission bursts contribute disproportionately to future HIV transmission, underscoring the value of detecting and responding to rapid transmission to reduce incidence. Bursts of rapid transmission may also contribute to enduring disparities in incidence among some key populations.

HIV传播对未来HIV感染的贡献,美国。
目的:估计艾滋病毒快速传播爆发对未来传播的影响,并描述受传播爆发影响的人群。设计:对美国国家艾滋病监测系统数据进行系统发育分析。方法:利用2014-2019年诊断为HIV感染的HIV感染者(PWH)序列,推断6个地理区域的时间尺度系统发育树。传输突发被定义为在一个检测周期内系统发育中有3个相邻的推断传输事件。我们计算了2015-2016年传输突发对2017-2019年传输的相对贡献,并与非传输突发进行了比较。然后,我们检测了2014-2019年任意滑动的2年期间的爆发,并使用单变量风险比评估了与传播爆发有关或来自传播爆发的个体特征的描述性关联。结果:2015-2016年参与传播爆发的5.6%的系统发育谱系贡献了2017-2019年推断传播事件的14.9%。参与传播爆发的世系对未来传播的相对贡献是不参与传播爆发的世系的2.94倍。诊断时年龄较低,自我认定为跨性别者或其他性别认同,或自认为是一名异性恋男性,男性与男性之间的性接触,注射吸毒,或男性与男性之间的性接触和注射吸毒,以及急性或早期感染期间的诊断与传播爆发的参与或产生最强烈的关联。结论:传播爆发对未来HIV传播的贡献不成比例,强调了检测和应对快速传播以降低发病率的价值。突发的快速传播也可能导致某些关键人群的发病率长期存在差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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