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  • Wiley  (2)
  • Bachmann, N  (2)
  • Kusejko, K  (2)
  • Yerly, S  (2)
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  • Wiley  (2)
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  • 1
    Online Resource
    Online Resource
    Using longitudinally sampled viral nucleotide sequences to characterize the drivers of HIV‐1 transmission
    Wiley ; 2021
    In:  HIV Medicine Vol. 22, No. 5 ( 2021-05), p. 346-359
    Details
    In: HIV Medicine, Wiley, Vol. 22, No. 5 ( 2021-05), p. 346-359
    Abstract: Understanding the drivers of HIV‐1 transmission is of importance for curbing the ongoing epidemic. Phylogenetic methods based on single viral sequences allow us to assess whether two individuals are part of the same viral outbreak, but cannot on their own assess who potentially transmitted the virus. We developed and assessed a molecular epidemiology method with the main aim to screen cohort studies for and to characterize individuals who are ‘potential HIV‐1 transmitters’, in order to understand the drivers of HIV‐1 transmission. Methods We developed and validated a molecular epidemiology approach using longitudinally sampled viral Sanger sequences to characterize potential HIV‐1 transmitters in the Swiss HIV Cohort Study. Results Our method was able to identify 279 potential HIV‐1 transmitters and allowed us to determine the main epidemiological and virological drivers of transmission. We found that the directionality of transmission was consistent with infection times for 72.9% of 85 potential HIV‐1 transmissions with accurate infection date estimates. Being a potential HIV‐1 transmitter was associated with risk factors including viral load [adjusted odds ratio multivariable (95% confidence interval): 1.86 (1.49–2.32)], syphilis coinfection [1.52 (1.06–2.19)] , and recreational drug use [1.45 (1.06–1.98)]. By contrast for the potential HIV‐1 recipients, this association was weaker or even absent [1.18 (0.82–1.72), 0.89 (0.52–1.55) and 1.53 (0.98–2.39), respectively] , indicating that inferred directionality of transmission is useful at the population level. Conclusions Our results indicate that longitudinally sampled Sanger sequences do not provide sufficient information to identify transmitters with high certainty at the individual level, but that they allow the drivers of transmission at the population level to be characterized.
    Type of Medium: Online Resource
    ISSN: 1464-2662 , 1468-1293
    URL: Issue
    URL: Article
    DOI: 10.1111/hiv.v22.5
    DOI: 10.1111/hiv.13030
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2020341-X
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Quantifying the drivers of HIV transmission and prevention in men who have sex with men: a population model‐based analysis in Switzerland
    Wiley ; 2018
    In:  HIV Medicine Vol. 19, No. 10 ( 2018-11), p. 688-697
    Details
    In: HIV Medicine, Wiley, Vol. 19, No. 10 ( 2018-11), p. 688-697
    Abstract: Despite the huge success of antiretroviral therapy ( ART ), there is an ongoing HIV epidemic among men who have sex with men ( MSM ) in resource‐rich countries. Understanding the driving factors underlying this process is important for curbing the epidemic. Methods We simulated the HIV epidemic in MSM in Switzerland by stratifying a mathematical model by CD 4 count, the care cascade and condom use. The model was parametrised with clinical, epidemiological and behavioural data from the Swiss HIV Cohort Study and surveys in the HIV ‐negative population. Results According to our model, 3.4% of the cases that would otherwise have occurred in 2008–2015 were prevented by early initiation of ART . Only 0.6% of the cases were attributable to a change in condom use in the HIV ‐positive population, as less usage is mainly seen in virally suppressed MSM . Most new infections were attributable to transmission from recently infected undiagnosed individuals. It was estimated that doubling the diagnosis rate would have resulted in 11.8% fewer cases in 2001–2015. Moreover, it was estimated that introducing pre‐exposure prophylaxis (Pr EP ) for 50% of those MSM not using condoms with occasional partners would have resulted in 22.6% fewer cases in 2012–2015. Conclusions By combining observational data on the relevant epidemiological and clinical processes with a mathematical model, we showed that the ‘test and treat’ approach is most effective in reducing the number of new cases. Only a moderate population‐level effect was estimated for early initiation of ART and a weak effect for the change in condom use of diagnosed MSM . Protecting HIV ‐negative individuals who are not using condoms with Pr EP was shown to have a major impact.
    Type of Medium: Online Resource
    ISSN: 1464-2662 , 1468-1293
    URL: Issue
    URL: Article
    DOI: 10.1111/hiv.2018.19.issue-10
    DOI: 10.1111/hiv.12660
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2020341-X
    Location Call Number Limitation Availability
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    Online Resource
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