Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
Biozentrum, University of Basel, Basel, Switzerland.
Curr Opin HIV AIDS. 2019 May;14(3):205-212. doi: 10.1097/COH.0000000000000537.
To discuss the recent HIV phylogenetic analyses examining HIV transmission patterns among and within risk groups.
Phylodynamic analysis has recently been applied to multiple HIV outbreaks among people who inject drugs to determine whether HIV transmission is ongoing. Large-scale analyses of datasets of HIV sequences collected for drug-resistance testing provide population-level insights into transmission patterns. One focus across world regions has been to investigate whether age-disparity is a driver of HIV transmission. In sub-Saharan Africa, researchers have examined transmission between heterosexuals and MSM and between high prevalence fishing communities and inland communities. In the US and the UK, cryptic risk groups such as nondisclosed MSM and the partners of transgender women are increasingly being uncovered based on their position in densely sampled molecular transmission networks.
Analysis of HIV genetic sequence can resolve viral transmission patterns between risk groups at unprecedented scales and levels of detail. Future research should focus on understanding the effect of missing data on inferences and the biases of different methods. Uncovering groups and patterns obscured from traditional epidemiolocal analyses is exciting but should not compromise the privacy of the groups in question.
讨论最近的 HIV 系统发育分析，以研究不同风险群体内部和之间的 HIV 传播模式。
系统发育动力学分析最近已应用于多人注射毒品的 HIV 爆发，以确定 HIV 是否在持续传播。对为耐药性检测收集的 HIV 序列数据集进行大规模分析，可深入了解人群传播模式。世界各地的一个重点是研究年龄差异是否是 HIV 传播的驱动因素。在撒哈拉以南非洲，研究人员研究了异性恋者和男男性接触者之间以及高流行渔业社区和内陆社区之间的传播。在美国和英国，根据在密集采样的分子传播网络中的位置，基于隐秘的风险群体（如未公开的男男性接触者和跨性别女性的伴侣），越来越多地发现了隐秘的风险群体。
分析 HIV 遗传序列可以以前所未有的规模和详细程度解析不同风险群体之间的病毒传播模式。未来的研究应集中于了解缺失数据对推断的影响和不同方法的偏差。揭示传统流行病学分析中隐藏的群体和模式令人兴奋，但不应损害相关群体的隐私。
