Characteristics and growth of the genetic HIV transmission network of Mexico City during 2020
Genre
Journal articleDate
2021-11-11Author
Davila-Conn, VanessaGarcia-Morales, Claudia
Matias-Florentino, Margarita
Lopez-Ortiz, Eduardo
Paz-Juarez, Hector E.
Beristain-Barreda, Angeles
Cardenas-Sandoval, Miroslava
Tapia-Trejo, Daniela
Lopez-Sanchez, Dulce M.
Mecerril-Rodriguez, Manuel
Garcia-Esparza, Pedro
Macias-Gonzalez, Israel
Iracheta-Hernandez, Patricia
Weaver, Steven
Wertheim, Joel O.
Reyes-Teran, Gustavo
Gonzalez-Rodriguez, Andrea
Avila-Rios, Santiago
Group
Institute for Genomics and Evolutionary Medicine (Temple University)Department
BiologySubject
Molecular epidemiologyGenetic clustering
Transmission network
HIV prevention
Public health
Mexico
Permanent link to this record
http://hdl.handle.net/20.500.12613/7589
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https://doi.org/10.1002/jia2.25836Abstract
Introduction: Molecular surveillance systems could provide public health benefits to focus strategies to improve the HIV care continuum. Here, we infer the HIV genetic network of Mexico City in 2020, and identify actively growing clusters that could represent relevant targets for intervention. Methods: All new diagnoses, referrals from other institutions, as well as persons returning to care, enrolling at the largest HIV clinic in Mexico City were invited to participate in the study. The network was inferred from HIV pol sequences, using pairwise genetic distance methods, with a locally hosted, secure version of the HIV-TRACE tool: Seguro HIV-TRACE. Socio-demographic, clinical and behavioural metadata were overlaid across the network to design focused prevention interventions. Results: A total of 3168 HIV sequences from unique individuals were included. One thousand and one-hundred and fifty (36%) sequences formed 1361 links within 386 transmission clusters in the network. Cluster size varied from 2 to 14 (63% were dyads). After adjustment for covariates, lower age (adjusted odds ratio [aOR]: 0.37, p<0.001; >34 vs. <24 years), being a man who has sex with men (MSM) (aOR: 2.47, p = 0.004; MSM vs. cisgender women), having higher viral load (aOR: 1.28, p<0.001) and higher CD4+ T cell count (aOR: 1.80, p<0.001; ≥500 vs. <200 cells/mm3) remained associated with higher odds of clustering. Compared to MSM, cisgender women and heterosexual men had significantly lower education (none or any elementary: 59.1% and 54.2% vs. 16.6%, p<0.001) and socio-economic status (low income: 36.4% and 29.0% vs. 18.6%, p = 0.03) than MSM. We identified 10 (2.6%) clusters with constant growth, for prioritized intervention, that included intersecting sexual risk groups, highly connected nodes and bridge nodes between possible sub-clusters with high growth potential. Conclusions: HIV transmission in Mexico City is strongly driven by young MSM with higher education level and recent infection. Nevertheless, leveraging network inference, we identified actively growing clusters that could be prioritized for focused intervention with demographic and risk characteristics that do not necessarily reflect the ones observed in the overall clustering population. Further studies evaluating different models to predict growing clusters are warranted. Focused interventions will have to consider structural and risk disparities between the MSM and the heterosexual populations.Citation
Dávila-Conn, V., García-Morales, C., Matías-Florentino, M., López-Ortiz, E., Paz-Juárez, H.E., Beristain-Barreda, Á., Cárdenas-Sandoval, M., Tapia-Trejo, D., López-Sánchez, D.M., Becerril-Rodríguez, M., García-Esparza, P., Macías-González, I., Iracheta-Hernández, P., Weaver, S., Wertheim, J.O., Reyes-Terán, G., González-Rodríguez, A. and Ávila-Ríos, S. (2021), Characteristics and growth of the genetic HIV transmission network of Mexico City during 2020. J Int AIDS Soc., 24: e25836. https://doi.org/10.1002/jia2.25836Citation to related work
Wiley Open AccessHas part
Journal of the International AIDS Society, Vol. 24, No. 11ADA compliance
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http://dx.doi.org/10.34944/dspace/7567