Phylogenetic clustering networks among heterosexual migrants with new HIV diagnoses post-migration in Australia

Sacks-Davis, Rachel; Chibo, Doris; Peach, Elizabeth; Aleksic, Eman; Crowe, Suzanne; El-Hayek, Carol; Marukutira, Tafireyi; Higgins, Nasra; Stoové, Mark; Hellard, Margaret

doi:10.1371/journal.pone.0237469

Cited by 5 publications

(6 citation statements)

References 30 publications

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“…Of the 22 CRF01_AE clusters seven (32%) contained exclusively infections among individuals reporting a transmission risk other than MSM, with the largest of these clusters only containing four infections. Our finding is similar to that of a recent study from the state of Victoria, Australia, which found that heterosexual transmissions rarely lead to more than one new infection within that state [29]. Overall, we found nine active growing clusters for CRF01_AE, of which seven contained infections from notifications in 2018.…”

Section: Discussionsupporting

confidence: 90%

Subtype‐specific differences in transmission cluster dynamics of HIV‐1 B and CRF01_AE in New South Wales, Australia

Giallonardo

Pinto

Keen

et al. 2021

J. Intern. AIDS Soc.

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Introduction The human immunodeficiency virus 1 (HIV‐1) pandemic is characterized by numerous distinct sub‐epidemics (clusters) that continually fuel local transmission. The aims of this study were to identify active growing clusters, to understand which factors most influence the transmission dynamics, how these vary between different subtypes and how this information might contribute to effective public health responses. Methods We used HIV‐1 genomic sequence data linked to demographic factors that accounted for approximately 70% of all new HIV‐1 notifications in New South Wales (NSW). We assessed differences in transmission cluster dynamics between subtype B and circulating recombinant form 01_AE (CRF01_AE). Separate phylogenetic trees were estimated using 2919 subtype B and 473 CRF01_AE sequences sampled between 2004 and 2018 in combination with global sequence data and NSW‐specific clades were classified as clusters, pairs or singletons. Significant differences in demographics between subtypes were assessed with Chi‐Square statistics. Results We identified 104 subtype B and 11 CRF01_AE growing clusters containing a maximum of 29 and 11 sequences for subtype B and CRF01_AE respectively. We observed a > 2‐fold increase in the number of NSW‐specific CRF01_AE clades over time. Subtype B clusters were associated with individuals reporting men who have sex with men (MSM) as their transmission risk factor, being born in Australia, and being diagnosed during the early stage of infection (p < 0.01). CRF01_AE infections clusters were associated with infections among individuals diagnosed during the early stage of infection (p < 0.05) and CRF01_AE singletons were more likely to be from infections among individuals reporting heterosexual transmission (p < 0.05). We found six subtype B clusters with an above‐average growth rate (>1.5 sequences / 6‐months) and which consisted of a majority of infections among MSM. We also found four active growing CRF01_AE clusters containing only infections among MSM. Finally, we found 47 subtype B and seven CRF01_AE clusters that contained a large gap in time (>1 year) between infections and may be indicative of intermediate transmissions via undiagnosed individuals. Conclusions The large number of active and growing clusters among MSM are the driving force of the ongoing epidemic in NSW for subtype B and CRF01_AE.

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Section: Discussionsupporting

confidence: 90%

Subtype‐specific differences in transmission cluster dynamics of HIV‐1 B and CRF01_AE in New South Wales, Australia

Giallonardo

Pinto

Keen

et al. 2021

J. Intern. AIDS Soc.

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“…Third, while CD4 count and VL data were used to approximate duration of HIV infection, determining the recency of infection using validated methods (e.g., genetic sequence diversity) [ 27 , 28 , 29 ] may have provided complimentary information to estimate the timing of HIV acquisition. Finally, social desirability bias may have impacted the reporting of sexual orientation, particularly among MSM [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies, many using Bayesian methods, have shown significant post-migration HIV acquisition among certain migrant populations [ 2 , 8 , 9 , 10 ]. Timely HIV screening and linkage to care thus becomes particularly important for preventing both individual-level morbidity and mortality and onward transmission.…”

Section: Introductionmentioning

confidence: 99%

“…Phylogenetic analysis, a form of molecular epidemiology, has been increasingly used to characterize HIV transmission and tailor potential prevention responses to better inform public health [ 15 , 16 ]. Recent studies using phylogenetic analysis found that small heterosexual clusters among migrants were commonly composed of people living with HIV from a single birth country [ 10 , 17 ]. Given the evolving epidemiology of HIV-1 in Canada, we aimed to use phylogenetics to characterize HIV-1 transmission clusters among newly-diagnosed asylum seekers and to better understand the role of networks in local HIV transmission.…”

Section: Introductionmentioning

confidence: 99%

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Phylogenetic Clustering among Asylum Seekers with New HIV-1 Diagnoses in Montreal, QC, Canada

Park

Brenner

Ibanescu

et al. 2021

Viruses

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Migrants are at an increased risk of HIV acquisition. We aimed to use phylogenetics to characterize transmission clusters among newly-diagnosed asylum seekers and to understand the role of networks in local HIV transmission. Retrospective chart reviews of asylum seekers linked to HIV care between 1 June 2017 and 31 December 2018 at the McGill University Health Centre and the Jewish General Hospital in Montreal were performed. HIV-1 partial pol sequences were analyzed among study participants and individuals in the provincial genotyping database. Trees were reconstructed using MEGA10 neighbor-joining analysis. Clustering of linked viral sequences was based on a strong bootstrap support (>97%) and a short genetic distance (<0.01). Overall, 10,645 provincial sequences and 105 asylum seekers were included. A total of 13/105 participant sequences (12%; n = 7 males) formed part of eight clusters. Four clusters (two to three people) included only study participants (n = 9) and four clusters (two to three people) included four study participants clustered with six individuals from the provincial genotyping database. Six (75%) clusters were HIV subtype B. We identified the presence of HIV-1 phylogenetic clusters among asylum seekers and at a population-level. Our findings highlight the complementary role of cohort data and population-level genotypic surveillance to better characterize transmission clusters in Quebec.

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“…Thus, now is the time where a combined effort could lead to the virtual elimination of HIV transmission in Australia. Several efforts have been made towards this goal through institutional partnerships and funding such as the New South Wales HIV Prevention Partnership Project 2022–2026 ( Kirby, 2022 ), individual molecular epidemiological studies ( Di Giallonardo et al., 2019 ; Sacks-Davis et al., 2020 ; Pinto et al., 2018 ), the continuation of the needle and syringe program, Healthcare worker training, and the expansion of PrEP prescribers ( NSWH, 2020 ).…”

Section: Why Does Australia Need Molecular Epidemiology As a Pillar I...mentioning

confidence: 99%

Molecular epidemiology to aid virtual elimination of HIV transmission in Australia

Obeng,

Kelleher,

Di Giallonardo

2024

Virus Research

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Phylogenetic clustering networks among heterosexual migrants with new HIV diagnoses post-migration in Australia

Abstract: Background It is estimated that approximately half of new HIV diagnoses among heterosexual migrants in Victoria, Australia, were acquired post-migration. We investigated the characteristics of phylogenetic clusters in notified cases of HIV among heterosexual migrants.

Cited by 5 publications

References 30 publications

Subtype‐specific differences in transmission cluster dynamics of HIV‐1 B and CRF01_AE in New South Wales, Australia

Subtype‐specific differences in transmission cluster dynamics of HIV‐1 B and CRF01_AE in New South Wales, Australia

Phylogenetic Clustering among Asylum Seekers with New HIV-1 Diagnoses in Montreal, QC, Canada

Molecular epidemiology to aid virtual elimination of HIV transmission in Australia

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