Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
U.S. Public Health Service, Atlanta, GA 30329, USA.
Viruses. 2021 Mar 30;13(4):577. doi: 10.3390/v13040577.
Molecular cluster detection analyzes HIV sequences to identify rapid HIV transmission and inform public health responses. We describe changes in the capability to detect molecular clusters and in geographic variation in transmission dynamics. We examined the reporting completeness of HIV-1 polymerase sequences in quarterly National HIV Surveillance System datasets from December 2015 to December 2019. Priority clusters were identified quarterly. To understand populations recently affected by rapid transmission, we described the transmission risk and race/ethnicity of people in clusters first detected in 2018-2019. During December 2015 to December 2019, national sequence completeness increased from 26% to 45%. Of the 1212 people in the 136 clusters first detected in 2018-2019, 69% were men who have sex with men (MSM) and 11% were people who inject drugs (PWID). State-by-state analysis showed substantial variation in transmission risk and racial/ethnic groups in clusters of rapid transmission. HIV sequence reporting has increased nationwide. Molecular cluster analysis identifies rapid transmission in varied populations and identifies emerging patterns of rapid transmission in specific population groups, such as PWID, who, in 2015-2016, comprised only 1% of people in such molecular clusters. These data can guide efforts to focus, tailor, and scale up prevention and care services for these populations.
分子簇检测分析 HIV 序列，以识别 HIV 快速传播并为公共卫生应对措施提供信息。我们描述了检测分子簇的能力的变化，以及传播动态的地理差异。我们检查了 2015 年 12 月至 2019 年 12 月期间每季度国家艾滋病毒监测系统数据集中 HIV-1 聚合酶序列的报告完整性。每季度确定优先集群。为了了解最近受到快速传播影响的人群，我们描述了 2018-2019 年首次发现的集群中人群的传播风险和种族/民族。在 2015 年 12 月至 2019 年 12 月期间，全国序列完整性从 26%增加到 45%。在 2018-2019 年首次发现的 136 个集群中的 1212 人中，69%是男男性行为者（MSM），11%是注射毒品者（PWID）。按州分析显示，快速传播集群中的传播风险和种族/族裔群体存在很大差异。全国范围内 HIV 序列报告有所增加。分子簇分析确定了不同人群中的快速传播，并确定了特定人群中快速传播的新出现模式，例如 PWID，他们在 2015-2016 年仅占此类分子簇中人群的 1%。这些数据可以指导集中、调整和扩大针对这些人群的预防和护理服务的工作。
