Little Susan J, Kosakovsky Pond Sergei L, Anderson Christy M, Young Jason A, Wertheim Joel O, Mehta Sanjay R, May Susanne, Smith Davey M
Department of Medicine, University of California, San Diego, La Jolla, California, United States of America.
Department of Biostatistics, University of Washington, Seattle, Washington, United States of America.
PLoS One. 2014 Jun 5;9(6):e98443. doi: 10.1371/journal.pone.0098443. eCollection 2014.
To reconstruct the local HIV-1 transmission network from 1996 to 2011 and use network data to evaluate and guide efforts to interrupt transmission.
HIV-1 pol sequence data were analyzed to infer the local transmission network.
We analyzed HIV-1 pol sequence data to infer a partial local transmission network among 478 recently HIV-1 infected persons and 170 of their sexual and social contacts in San Diego, California. A transmission network score (TNS) was developed to estimate the risk of HIV transmission from a newly diagnosed individual to a new partner and target prevention interventions.
HIV-1 pol sequences from 339 individuals (52.3%) were highly similar to sequences from at least one other participant (i.e., clustered). A high TNS (top 25%) was significantly correlated with baseline risk behaviors (number of unique sexual partners and insertive unprotected anal intercourse (p = 0.014 and p = 0.0455, respectively) and predicted risk of transmission (p<0.0001). Retrospective analysis of antiretroviral therapy (ART) use, and simulations of ART targeted to individuals with the highest TNS, showed significantly reduced network level HIV transmission (p<0.05).
Sequence data from an HIV-1 screening program focused on recently infected persons and their social and sexual contacts enabled the characterization of a highly connected transmission network. The network-based risk score (TNS) was highly correlated with transmission risk behaviors and outcomes, and can be used identify and target effective prevention interventions, like ART, to those at a greater risk for HIV-1 transmission.
重建1996年至2011年当地的HIV-1传播网络，并利用网络数据评估和指导阻断传播的工作。
分析HIV-1 pol序列数据以推断当地传播网络。
我们分析了HIV-1 pol序列数据，以推断加利福尼亚州圣地亚哥478名近期感染HIV-1的人和他们170名性接触者及社会接触者之间的部分当地传播网络。开发了一种传播网络评分（TNS）来估计新诊断个体将HIV传播给新伴侣的风险，并确定预防干预措施的目标。
339名个体（52.3%）的HIV-1 pol序列与至少一名其他参与者的序列高度相似（即聚类）。高TNS（前25%）与基线风险行为（独特性伴侣数量和插入式无保护肛交，分别为p = 0.014和p = 0.0455）以及预测的传播风险（p<0.0001）显著相关。对抗逆转录病毒疗法（ART）使用情况的回顾性分析以及针对TNS最高个体的ART模拟显示，网络层面的HIV传播显著减少（p<0.05）。
来自一项针对近期感染者及其性接触者和社会接触者的HIV-1筛查项目的序列数据，能够描绘出一个高度连通的传播网络。基于网络的风险评分（TNS）与传播风险行为及结果高度相关，可用于识别并将有效的预防干预措施（如ART）靶向那些HIV-1传播风险更高的人群。
