The Role of Phylogenetics in Unravelling Patterns of HIV Transmission towards Epidemic Control: The Quebec Experience (2002-2020)

被引：16

作者：

Brenner, Bluma G. ^{[1
,2
,3
]}

Ibanescu, Ruxandra-Ilinca ^{[1
]}

Osman, Nathan ^{[1
,2
]}

Cuadra-Foy, Ernesto ^{[1
,2
]}

Oliveira, Maureen ^{[1
]}

Chaillon, Antoine ^{[4
]}

Stephens, David ^{[5
]}

Hardy, Isabelle ^{[6
,7
]}

Routy, Jean-Pierre ^{[8
]}

Thomas, Rejean ^{[9
]}

Baril, Jean-Guy ^{[10
]}

Leblanc, Roger ^{[11
]}

Tremblay, Cecile ^{[6
,7
]}

Roger, Michel ^{[6
,7
]}

机构：

[1] McGill Ctr Viral Dis, Lady Davis Inst Med Res, Montreal, PQ H3T 1E2, Canada

[2] McGill Univ, Dept Microbiol & Immunol, Montreal, PQ H4A 3J1, Canada

[3] McGill Univ, Dept Med Surg Infect Dis, Surg, Infect Dis, Montreal, PQ H3A 2M7, Canada

[4] Univ Calif San Diego, Dept Med, San Diego, CA 93903 USA

[5] McGill Univ, Dept Math & Stat, Montreal, PQ H3A 0B9, Canada

[6] Ctr Hosp Univ Montreal CHUM, Dept Microbiol & Immunol, Montreal, PQ H2X 0C1, Canada

[7] Ctr Hosp Univ Montreal CHUM, Ctr Rech, Montreal, PQ H2X 0C1, Canada

[8] McGill Univ, Chron Viral Illness Serv, Hlth Ctr, Montreal, PQ H3A 3J1, Canada

[9] Clin Med Actuel, Montreal, PQ H2L 4P9, Canada

[10] Clin Med Urbaine Quartier Latin, Montreal, PQ H2L 4E9, Canada

[11] Clin Med OPUS, Montreal, PQ H3A 1T1, Canada

[12] CHUM, Ctr Rech, Montreal PHI Cohort Reseau Sida & Malad Infect, Montreal, PQ H2X 0A9, Canada

来源：

VIRUSES-BASEL | 2021年 / 13卷 / 08期

基金：

美国国家卫生研究院;

关键词：

HIV-1; transmission; men having sex with men; non-B subtypes; phylogenetics; HIV-TRACE; treatment-as-prevention; migration; INFECTION; PREVENTION; DIVERSITY; CLUSTERS; SPREAD; MARKER;

D O I：

10.3390/v13081643

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Phylogenetics has been advanced as a structural framework to infer evolving trends in the regional spread of HIV-1 and guide public health interventions. In Quebec, molecular network analyses tracked HIV transmission dynamics from 2002-2020 using MEGA10-Neighbour-joining, HIV-TRACE, and MicrobeTrace methodologies. Phylogenetics revealed three patterns of viral spread among Men having Sex with Men (MSM, n = 5024) and heterosexuals (HET, n = 1345) harbouring subtype B epidemics as well as B and non-B subtype epidemics (n = 1848) introduced through migration. Notably, half of new subtype B infections amongst MSM and HET segregating as solitary transmissions or small cluster networks (2-5 members) declined by 70% from 2006-2020, concomitant to advances in treatment-as-prevention. Nonetheless, subtype B epidemic control amongst MSM was thwarted by the ongoing genesis and expansion of super-spreader large cluster variants leading to micro-epidemics, averaging 49 members/cluster at the end of 2020. The growth of large clusters was related to forward transmission cascades of untreated early-stage infections, younger at-risk populations, more transmissible/replicative-competent strains, and changing demographics. Subtype B and non-B subtype infections introduced through recent migration now surpass the domestic epidemic amongst MSM. Phylodynamics can assist in predicting and responding to active, recurrent, and newly emergent large cluster networks, as well as the cryptic spread of HIV introduced through migration.

引用

页数：16