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Lancet HIV. 2018 Nov;5(11):e656-e666. doi: 10.1016/S2352-3018(18)30134-6. Epub 2018 Aug 30.

Ethical considerations in global HIV phylogenetic research.

Author information

1
Institute for Global Health, University College London, London, UK.
2
Division of Infection and Immunity, University College London, London, UK. Electronic address: a.hoppe@ucl.ac.uk.
3
The Wellcome Centre for Ethics and Humanities (Ethox), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
4
Division of AIDS, National Institutes of Health, Bethesda, MD, USA.
5
Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ, USA.
6
Zambart, University of Zambia, Lusaka, Zambia.
7
Berman Institute of Bioethics and School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
8
Center for Genomics and Society, Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA.
9
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
10
Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA.
11
Community Support, Social Justice and Inclusion Department, Geneva, Switzerland; School of Law, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
12
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
13
Clinical and Epidemiological Virology, Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven-University of Leuven, Leuven, Belgium; Center for Global Health and Tropical Medicine, Unidade de Microbiologia, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
14
Africa Health Research Institute, KwaZulu-Natal, South Africa; Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.
15
Bill & Melinda Gates Foundation, Washington, DC, USA.
16
Institute for Global Health, University College London, London, UK; Africa Health Research Institute, KwaZulu-Natal, South Africa.
17
Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Rakai Community Cohort Study, Rakai Health Sciences Program, Kalisizo, Uganda.
18
Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.
19
Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
20
Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
21
Division of Infection and Immunity, University College London, London, UK; Africa Health Research Institute, KwaZulu-Natal, South Africa.

Abstract

Phylogenetic analysis of pathogens is an increasingly powerful way to reduce the spread of epidemics, including HIV. As a result, phylogenetic approaches are becoming embedded in public health and research programmes, as well as outbreak responses, presenting unique ethical, legal, and social issues that are not adequately addressed by existing bioethics literature. We formed a multidisciplinary working group to explore the ethical issues arising from the design of, conduct in, and use of results from HIV phylogenetic studies, and to propose recommendations to minimise the associated risks to both individuals and groups. We identified eight key ethical domains, within which we highlighted factors that make HIV phylogenetic research unique. In this Review, we endeavoured to provide a framework to assist researchers, public health practitioners, and funding institutions to ensure that HIV phylogenetic studies are designed, done, and disseminated in an ethical manner. Our conclusions also have broader relevance for pathogen phylogenetics.

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