Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico.
Coordinating Commission of the National Institutes of Health and High Specialty Hospitals, Ministry of Health, Mexico City, Mexico.
J Virol. 2022 Jul 27;96(14):e0070822. doi: 10.1128/jvi.00708-22. Epub 2022 Jun 28.
Evolutionary analyses of viral sequences can provide insights into transmission dynamics, which in turn can optimize prevention interventions. Here, we characterized the dynamics of HIV transmission within the Mexico City metropolitan area. HIV sequences from persons recently diagnosed at the largest HIV clinic in Mexico City (between 2016 and 2021) were annotated with demographic/geographic metadata. A multistep phylogenetic approach was applied to identify putative transmission clades. A data set of publicly available sequences was used to assess international introductions. Clades were analyzed with a discrete phylogeographic model to evaluate the timing and intensity of HIV introductions and transmission dynamics among municipalities in the region. A total of 6,802 sequences across 96 municipalities (5,192 from Mexico City and 1,610 from the neighboring State of Mexico) were included (93.6% cisgender men, 5.0% cisgender women, and 1.3% transgender women); 3,971 of these sequences formed 1,206 clusters, involving 78 municipalities, including 89 clusters of ≥10 sequences. Discrete phylogeographic analysis revealed (i) 1,032 viral introductions into the region, over one-half of which were from the United States, and (ii) 354 migration events between municipalities with high support (adjusted Bayes factor of ≥3). The most frequent viral migrations occurred between northern municipalities within Mexico City, i.e., Cuauhtémoc to Iztapalapa (5.2% of events), Iztapalapa to Gustavo A. Madero (5.4%), and Gustavo A. Madero to Cuauhtémoc (6.5%). Our analysis illustrates the complexity of HIV transmission within the Mexico City metropolitan area but also identifies a spatially active transmission area involving a few municipalities in the north of the city, where targeted interventions could have a more pronounced effect on the entire regional epidemic. Phylogeographic investigation of the Mexico City HIV epidemic illustrates the complexity of HIV transmission in the region. An active transmission area involving a few municipalities in the north of the city, with transmission links throughout the region, is identified and could be a location where targeted interventions could have a more pronounced effect on the entire regional epidemic, compared with those dispersed in other manners.
病毒序列的进化分析可以提供有关传播动态的见解，从而优化预防干预措施。在这里，我们描述了墨西哥城大都市区内 HIV 传播的动态。对最近在墨西哥城最大的 HIV 诊所诊断出的患者（2016 年至 2021 年期间）的 HIV 序列进行了人口统计学/地理元数据注释。应用多步骤系统发育方法来识别可能的传播谱系。使用公开可用序列数据集评估国际传入。对谱系进行离散系统地理学模型分析，以评估该地区各城市之间 HIV 传入和传播动态的时间和强度。共纳入了 96 个城市的 6802 个序列（5192 个来自墨西哥城，1610 个来自邻近的墨西哥州）（93.6%顺性别男性，5.0%顺性别女性，1.3%跨性别女性）；其中 3971 个序列形成了 1206 个簇，涉及 78 个城市，包括 89 个≥10 个序列的簇。离散系统地理学分析显示 (i) 有 1032 次病毒传入该地区，其中一半以上来自美国，以及 (ii) 89 个簇之间有 354 次迁移事件，具有高支持度（调整后的贝叶斯因子≥3）。最常见的病毒迁移发生在墨西哥城北部的几个城市之间，即瓦哈卡到伊兹塔帕拉帕（5.2%的事件），伊兹塔帕拉帕到古斯塔沃·A·马德罗（5.4%），以及古斯塔沃·A·马德罗到瓦哈卡（6.5%）。我们的分析说明了墨西哥城大都市区内 HIV 传播的复杂性，但也确定了一个涉及城市北部几个城市的活跃传播区域，该区域与整个地区的传播具有联系，在这些城市采取有针对性的干预措施可能会对整个地区的疫情产生更明显的影响。 对墨西哥城 HIV 流行的系统地理学研究说明了该地区 HIV 传播的复杂性。确定了一个涉及城市北部几个城市的活跃传播区域，该区域与整个地区的传播具有联系，与以其他方式分散的传播相比，在这些城市采取有针对性的干预措施可能会对整个地区的疫情产生更明显的影响。
