Phylogenetic Studies of Transmission Dynamics in Generalized HIV Epidemics: An Essential Tool Where the Burden is Greatest?

被引：72

作者：

Dennis, Ann M. ^{[1
]}

Herbeck, Joshua T. ^{[2
]}

Brown, Andrew L. ^{[3
]}

Kellam, Paul ^{[4
,5
]}

de Oliveira, Tulio ^{[6
]}

Pillay, Deenan ^{[5
]}

Fraser, Christophe ^{[7
]}

Cohen, Andmyron S. ^{[1
]}

机构：

[1] Univ N Carolina, Div Infect Dis, Chapel Hill, NC 27999 USA

[2] Univ Washington, Dept Microbiol, Seattle, WA 98195 USA

[3] Univ Edinburgh, Inst Evolutionary Biol, Edinburgh, Midlothian, Scotland

[4] Wellcome Trust Sanger Inst, Cambridge, England

[5] UCL, Div Infect & Immun, London, England

[6] Univ Kwazula Natal, Wellcome Trust Africa Ctr Hlth & Populat Studies, ZA, Durban, South Africa

[7] Univ London Imperial Coll Sci Technol & Med, Dept Infect Dis Epidemiol, London, England

来源：

JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES | 2014年 / 67卷 / 02期

基金：

美国国家卫生研究院;

关键词：

HIV-1; molecular epidemiology; phylogenetic; transmission networks; sub-Saharan Africa; HUMAN-IMMUNODEFICIENCY-VIRUS; FEMALE SEX WORKERS; ACTIVE ANTIRETROVIRAL THERAPY; TRANSMITTED DRUG-RESISTANCE; RESOURCE-LIMITED SETTINGS; SUBTYPE-C HIV-1; MOLECULAR EPIDEMIOLOGY; GENETIC DIVERSITY; NAIVE PATIENTS; MULTIPLE INTRODUCTIONS;

D O I：

10.1097/QAI.0000000000000271

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Efficient and effective HIV prevention measures for generalized epidemics in sub-Saharan Africa have not yet been validated at the population level. Design and impact evaluation of such measures requires fine-scale understanding of local HIV transmission dynamics. The novel tools of HIV phylogenetics and molecular epidemiology may elucidate these transmission dynamics. Such methods have been incorporated into studies of concentrated HIV epidemics to identify proximate and determinant traits associated with ongoing transmission. However, applying similar phylogenetic analyses to generalized epidemics, including the design and evaluation of prevention trials, presents additional challenges. Here we review the scope of these methods and present examples of their use in concentrated epidemics in the context of prevention. Next, we describe the current uses for phylogenetics in generalized epidemics and discuss their promise for elucidating transmission patterns and informing prevention trials. Finally, we review logistic and technical challenges inherent to large-scale molecular epidemiological studies of generalized epidemics and suggest potential solutions.

引用

页码：181 / 195

页数：15

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