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Elife. 2017 Sep 12;6. pii: e28721. doi: 10.7554/eLife.28721.

Assessing the danger of self-sustained HIV epidemics in heterosexuals by population based phylogenetic cluster analysis.

Author information

1
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
2
Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
3
Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.
4
Division of Immunology and Allergy, University Hospital Lausanne, Lausanne, Switzerland.
5
Molecular Virology, Department of Biomedicine - Petersplatz, University of Basel, Basel, Switzerland.
6
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
7
Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland.
8
Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
9
Service of Infectious Diseases, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
10
Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.
11
Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
#
Contributed equally

Abstract

Assessing the danger of transition of HIV transmission from a concentrated to a generalized epidemic is of major importance for public health. In this study, we develop a phylogeny-based statistical approach to address this question. As a case study, we use this to investigate the trends and determinants of HIV transmission among Swiss heterosexuals. We extract the corresponding transmission clusters from a phylogenetic tree. To capture the incomplete sampling, the delayed introduction of imported infections to Switzerland, and potential factors associated with basic reproductive number R0, we extend the branching process model to infer transmission parameters. Overall, the R0 is estimated to be 0.44 (95%-confidence interval 0.42-0.46) and it is decreasing by 11% per 10 years (4%-17%). Our findings indicate rather diminishing HIV transmission among Swiss heterosexuals far below the epidemic threshold. Generally, our approach allows to assess the danger of self-sustained epidemics from any viral sequence data.

KEYWORDS:

HIV; basic reproductive number; concentrated vs. generalised epidemic; epidemiology; global health; heterosexual; infectious disease; microbiology; molecular epidemiology; transmission; virus

PMID:
28895527
PMCID:
PMC5650480
DOI:
10.7554/eLife.28721
[Indexed for MEDLINE]
Free PMC Article

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