Molecular network-based intervention brings us closer to ending the HIV pandemic

Abstract

Precise identification of HIV transmission among populations is a key step in public health responses. However, the HIV transmission network is usually difficult to determine. HIV molecular networks can be determined by phylogenetic approach, genetic distance-based approach, and a combination of both approaches. These approaches are increasingly used to identify transmission networks among populations, reconstruct the history of HIV spread, monitor the dynamics of HIV transmission, guide targeted intervention on key subpopulations, and assess the effects of interventions. Simulation and retrospective studies have demonstrated that these molecular network-based interventions are more cost-effective than random or traditional interventions. However, we still need to address several challenges to improve the practice of molecular network-guided targeting interventions to finally end the HIV epidemic. The data remain limited or difficult to obtain, and more automatic real-time tools are required. In addition, molecular and social networks must be combined, and technical parameters and ethnic issues warrant further studies.

Dynamics of HIV-1 Molecular Networks Reveal Effective Control of Large Transmission Clusters in an Area Affected by an Epidemic of Multiple HIV Subtypes

“…Studies on HIV evolution-which have mainly focused on HIV-1 subtype B-have supported threshold selection and molecular network-guided applications; 1.5% was selected as the optimal threshold based on a rate of evolution of 1% every 10 years for the pol gene (Smith et al, 2009;Hightower et al, 2013). Nearly all molecular network studies on non-B HIV have used the subtype B threshold (Bon et al, 2010;Parczewski et al, 2012;Rose et al, 2017;Fabeni et al, 2019), however, the threshold for subtype B are also appropriate for non-B viral strains have not been fully explored (Han et al, 2020).…”

“…The rapid evolution of human immunodeficiency virus (HIV) leaves measurable footprints in the viral genome that can be used for epidemic surveillance by phylogenetic analysis (Hassan et al, 2017). In recent years, a simplified genetic distance-based method has increasingly been used to infer HIV-1 networks in the population, in which a molecular cluster represents a group of individuals infected with genetically similar HIV strains (Smith et al, 2009;US-CDC, 2018;Han et al, 2020). The expansion of molecular clusters represents recent and ongoing HIV transmission, and key subpopulations associated with such clusters are targets for prioritized interventions such as partner tracing and HIV testing through partner services (Green et al, 2017) for diagnosis of unknown HIV-positive cases (Green et al, 2017).…”

Epidemiology and Molecular Transmission Characteristics of HIV in the Capital City of Anhui Province in China

“…Recent studies on the application of new techniques and methods in molecular epidemiology have shown the power of various HIV gene sequence and analysis tools in improving transmission detection and intervention guidance [4][5][6]. The HIV molecular network is a type of transmission analysis based on the group model, which considers a potential transmission relationship between the infected people connected together.…”

New Technological Developments in Identification and Monitoring of New and Emerging Infections

“…Apart from the value of molecular epidemiology to study the history of the HIV-1 pandemic, identifying transmission clusters is an important tool in attempts to end HIV epidemics on country level ( Han et al, 2020 ). Identifying transmission clusters and acting on these by providing additional support services form part of the United States strategy that aims to end HIV transmission by 2030 ( Nichols and Kissler, 2020 ).…”